Provider Demographics
NPI:1780671420
Name:LAW, CANDACE (DC)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:LAW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 S FORREST ST
Mailing Address - Street 2:P.O. BOX 382
Mailing Address - City:DOUGLASS
Mailing Address - State:KS
Mailing Address - Zip Code:67039-8829
Mailing Address - Country:US
Mailing Address - Phone:316-746-2201
Mailing Address - Fax:316-746-2245
Practice Address - Street 1:226 S FORREST ST
Practice Address - Street 2:
Practice Address - City:DOUGLASS
Practice Address - State:KS
Practice Address - Zip Code:67039-8829
Practice Address - Country:US
Practice Address - Phone:316-746-2201
Practice Address - Fax:316-746-2245
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS62456OtherBLUE CROSS BLUE SHIELD
KS9308350OtherPHCS, FAMILY HEALTH AMERICA
KS9085125OtherCIGNA
KSP00182560OtherRAILROAD MEDICARE #
KS8187OtherPHS PROVIDER #
KSV01012Medicare UPIN
KS660202001Medicare PIN