Provider Demographics
NPI:1912397027
Name:RUMMERFIELD, KENNETH W (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:W
Last Name:RUMMERFIELD
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 1:124 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-9422
Mailing Address - Country:US
Mailing Address - Phone:816-779-1022
Mailing Address - Fax:816-779-1022
Practice Address - Street 1:124 W NORTH ST
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9422
Practice Address - Country:US
Practice Address - Phone:816-779-1022
Practice Address - Fax:816-779-1022
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015001862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor