Provider Demographics
NPI:1740316702
Name:VEACH, BRUCE A (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:VEACH
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 1:125 W A AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:KS
Mailing Address - Zip Code:67068-1306
Mailing Address - Country:US
Mailing Address - Phone:620-532-1111
Mailing Address - Fax:620-532-3349
Practice Address - Street 1:125 W A AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:KS
Practice Address - Zip Code:67068-1306
Practice Address - Country:US
Practice Address - Phone:620-532-1111
Practice Address - Fax:620-532-3349
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-C3907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062169Medicare PIN