Provider Demographics
NPI:1922170307
Name:ENS, ALVIN DWIGHT (DC)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:DWIGHT
Last Name:ENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:6230 NIEMAN RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2902
Mailing Address - Country:US
Mailing Address - Phone:913-962-7800
Mailing Address - Fax:913-962-7801
Practice Address - Street 1:6230 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2902
Practice Address - Country:US
Practice Address - Phone:913-962-7800
Practice Address - Fax:913-962-7801
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0104126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU39266Medicare UPIN