Provider Demographics
NPI:1295909323
Name:IODICE, KIRK JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:JAMES
Last Name:IODICE
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 1:801 N. MUR-LEN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062
Mailing Address - Country:US
Mailing Address - Phone:913-764-2271
Mailing Address - Fax:913-764-2276
Practice Address - Street 1:801 N MUR-LEN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062
Practice Address - Country:US
Practice Address - Phone:913-764-2271
Practice Address - Fax:913-764-2276
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor