Provider Demographics
NPI:1902000607
Name:STEVENS, RYAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:E
Last Name:STEVENS
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 1:2000 W 47TH PL
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1803
Mailing Address - Country:US
Mailing Address - Phone:816-729-0947
Mailing Address - Fax:816-216-7177
Practice Address - Street 1:2000 W 47TH PL
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-1803
Practice Address - Country:US
Practice Address - Phone:816-729-0947
Practice Address - Fax:816-216-7177
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5024111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5024 LICENSE FOR DCOtherCHIROPRATOR