Provider Demographics
NPI:1427440064
Name:ISOM, JOSHUA MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:ISOM
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 1:15400 W 80TH PL
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1533
Mailing Address - Country:US
Mailing Address - Phone:191-373-5956
Mailing Address - Fax:913-273-0009
Practice Address - Street 1:7904 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2733
Practice Address - Country:US
Practice Address - Phone:719-369-6968
Practice Address - Fax:913-273-0009
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor