Provider Demographics
NPI:1831556836
Name:MEYER, COLIN LYNN CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:COLIN
Middle Name:LYNN CHARLES
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 1:16650 S LACKMAN RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-9553
Mailing Address - Country:US
Mailing Address - Phone:913-515-5347
Mailing Address - Fax:
Practice Address - Street 1:16650 S LACKMAN RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-9553
Practice Address - Country:US
Practice Address - Phone:913-515-5347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05757111N00000X
MO2015040816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor