Provider Demographics
NPI:1881877546
Name:BONCI, ANDREW S (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:BONCI
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 1:5830 WOODSON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2762
Mailing Address - Country:US
Mailing Address - Phone:913-236-9007
Mailing Address - Fax:
Practice Address - Street 1:5830 WOODSON RD STE 102
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2762
Practice Address - Country:US
Practice Address - Phone:913-236-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor