Provider Demographics
NPI:1356323513
Name:ECKE, DENNIS G (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:G
Last Name:ECKE
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 1:1023 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-4219
Mailing Address - Country:US
Mailing Address - Phone:620-792-2486
Mailing Address - Fax:
Practice Address - Street 1:1023 JACKSON ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4219
Practice Address - Country:US
Practice Address - Phone:620-792-2486
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST43795Medicare UPIN