Provider Demographics
NPI:1356376776
Name:SNOW, RICHARD ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLEN
Last Name:SNOW
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 1:9163 W 133RD ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4333
Mailing Address - Country:US
Mailing Address - Phone:913-814-0022
Mailing Address - Fax:913-814-0432
Practice Address - Street 1:9163 W 133RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4333
Practice Address - Country:US
Practice Address - Phone:913-814-0022
Practice Address - Fax:913-814-0432
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q660000Medicare ID - Type Unspecified
KSQ660000Medicare PIN
U99648Medicare UPIN
KSQ66C992Medicare Oscar/Certification