Provider Demographics
NPI:1285223974
Name:MEIDL, NATHANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:MEIDL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11450 LAMAR AVE UNIT 3440
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1784
Mailing Address - Country:US
Mailing Address - Phone:952-693-1801
Mailing Address - Fax:
Practice Address - Street 1:7423 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-1975
Practice Address - Country:US
Practice Address - Phone:913-579-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor