Provider Demographics
NPI:1285698316
Name:HARDEN, WESLEY A (DC)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:A
Last Name:HARDEN
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 1:240 E FISCHER LN
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:KS
Mailing Address - Zip Code:67068-9000
Mailing Address - Country:US
Mailing Address - Phone:620-532-2510
Mailing Address - Fax:
Practice Address - Street 1:5830 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2840
Practice Address - Country:US
Practice Address - Phone:316-946-0606
Practice Address - Fax:316-946-0553
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04589111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU75293Medicare UPIN
KS062174Medicare ID - Type Unspecified