Provider Demographics
NPI:1427359801
Name:BATES, AMY JO (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:JO
Last Name:BATES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11791 W 112TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2737
Mailing Address - Country:US
Mailing Address - Phone:913-888-3338
Mailing Address - Fax:913-696-1908
Practice Address - Street 1:11791 W 112TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2737
Practice Address - Country:US
Practice Address - Phone:913-888-3338
Practice Address - Fax:913-696-1908
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor