Provider Demographics
NPI:1376548495
Name:IVY PRICE, JOYCE KAREN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:KAREN
Last Name:IVY PRICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:JOYCE
Other - Middle Name:KAREN
Other - Last Name:DIGISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:8404 W 13TH ST N
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2978
Mailing Address - Country:US
Mailing Address - Phone:316-945-9096
Mailing Address - Fax:316-722-1120
Practice Address - Street 1:8404 W 13TH ST N
Practice Address - Street 2:SUITE 150
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2978
Practice Address - Country:US
Practice Address - Phone:316-945-9096
Practice Address - Fax:316-722-1120
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03778111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14185Medicare ID - Type Unspecified
KS007399Medicare PIN