Provider Demographics
NPI:1689675704
Name:KESLER, BRENT L (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:L
Last Name:KESLER
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 1:17350 W 163RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-8224
Mailing Address - Country:US
Mailing Address - Phone:913-568-9580
Mailing Address - Fax:913-273-5998
Practice Address - Street 1:112 E 17TH ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3800
Practice Address - Country:US
Practice Address - Phone:785-242-9393
Practice Address - Fax:785-242-9394
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062048OtherBCBS PROVIDER NUMBER
KS062048OtherBCBS PROVIDER NUMBER
KS062252Medicare PIN
KS062048Medicare PIN