Provider Demographics
NPI:1932643137
Name:STANLEY, REX DION (DC)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:DION
Last Name:STANLEY
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 1:2200 SUMMERLON CIR
Mailing Address - Street 2:SUITE D
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2900
Mailing Address - Country:US
Mailing Address - Phone:620-225-4139
Mailing Address - Fax:620-225-4286
Practice Address - Street 1:2200 SUMMERLON CIR
Practice Address - Street 2:SUITE D
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2900
Practice Address - Country:US
Practice Address - Phone:620-225-4139
Practice Address - Fax:620-225-4286
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor