Provider Demographics
NPI:1568461408
Name:RASMUSSEN, JOHN ERIC (DC, DABCO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:DC, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W 75TH ST
Mailing Address - Street 2:STE. 210
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3501
Mailing Address - Country:US
Mailing Address - Phone:913-677-4224
Mailing Address - Fax:913-677-4225
Practice Address - Street 1:1900 W 75TH ST
Practice Address - Street 2:STE. 210
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3501
Practice Address - Country:US
Practice Address - Phone:913-677-4224
Practice Address - Fax:913-677-4225
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC3600111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST42338Medicare UPIN
KS0004867Medicare ID - Type Unspecified