Provider Demographics
NPI:1518236009
Name:SPURGEON, RYAN DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DANIEL
Last Name:SPURGEON
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 1:12109 GRANADA ST
Mailing Address - Street 2:APT 1113
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-4224
Mailing Address - Country:US
Mailing Address - Phone:913-353-6655
Mailing Address - Fax:
Practice Address - Street 1:450 E SANTA FE ST
Practice Address - Street 2:STE 107
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3457
Practice Address - Country:US
Practice Address - Phone:913-353-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008723111N00000X
NM1883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor