Provider Demographics
NPI:1457490732
Name:LANE, BRIAN COLBY (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:COLBY
Last Name:LANE
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 1:407 S CLAIRBORNE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1744
Mailing Address - Country:US
Mailing Address - Phone:913-764-7722
Mailing Address - Fax:913-764-7723
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1744
Practice Address - Country:US
Practice Address - Phone:913-764-7722
Practice Address - Fax:913-764-7723
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10676013OtherBLUE CROSS GROUP NUMBER
KS10675015OtherBLUE CROSS PHYSICIAN ID
TX2077660OtherAETNA GROUP NUMBER
KS8460000Medicare ID - Type UnspecifiedGROUP NUMBER
KS8466595Medicare ID - Type UnspecifiedPHYSICIAN ID NUMBER