Provider Demographics
NPI:1972158145
Name:BANDA, HALI DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:HALI
Middle Name:DAWN
Last Name:BANDA
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 1:1247 S TYLER RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-1819
Mailing Address - Country:US
Mailing Address - Phone:316-440-5554
Mailing Address - Fax:
Practice Address - Street 1:1247 S TYLER RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-1819
Practice Address - Country:US
Practice Address - Phone:316-440-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor