Provider Demographics
NPI:1679856975
Name:PAULY, DANEN (DC)
Entity Type:Individual
Prefix:DR
First Name:DANEN
Middle Name:
Last Name:PAULY
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 1:463 S THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-2133
Mailing Address - Country:US
Mailing Address - Phone:816-637-5000
Mailing Address - Fax:
Practice Address - Street 1:463 S THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-2133
Practice Address - Country:US
Practice Address - Phone:816-637-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2012-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor