Provider Demographics
NPI:1972508166
Name:ALLEN, KEVIN DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DEAN
Last Name:ALLEN
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 1:215 S ANDOVER RD
Mailing Address - Street 2:STE E
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-7919
Mailing Address - Country:US
Mailing Address - Phone:316-733-0715
Mailing Address - Fax:316-733-5014
Practice Address - Street 1:215 S ANDOVER RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-7919
Practice Address - Country:US
Practice Address - Phone:316-733-0715
Practice Address - Fax:316-733-5014
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS9533OtherPREFERRED PLUS OF KANSAS
KS060813Medicare PIN
KS9533OtherPREFERRED PLUS OF KANSAS