Provider Demographics
NPI:1801803606
Name:MEYER, ADRIAN M (DC)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:M
Last Name:MEYER
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 1:119 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-2343
Mailing Address - Country:US
Mailing Address - Phone:785-738-5353
Mailing Address - Fax:785-738-5703
Practice Address - Street 1:119 N MILL ST
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-2343
Practice Address - Country:US
Practice Address - Phone:785-738-5353
Practice Address - Fax:785-738-5703
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST43822Medicare UPIN