Provider Demographics
NPI:1558850404
Name:SOUNAKHEN, DANIEL RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RYAN
Last Name:SOUNAKHEN
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 1:1429 W SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5060
Mailing Address - Country:US
Mailing Address - Phone:913-636-4202
Mailing Address - Fax:
Practice Address - Street 1:125 NE 91ST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-3329
Practice Address - Country:US
Practice Address - Phone:816-436-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018014854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor