Provider Demographics
NPI:1497275960
Name:BAXTER, BRETT NELSON (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:NELSON
Last Name:BAXTER
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 1:2413 E LOPER ST
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67219-1576
Mailing Address - Country:US
Mailing Address - Phone:316-617-2020
Mailing Address - Fax:
Practice Address - Street 1:10312 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3135
Practice Address - Country:US
Practice Address - Phone:316-722-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05850111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist