Provider Demographics
NPI:1538356076
Name:COMMERFORD, DAVID CHARLES (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:COMMERFORD
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 1:8024 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2116
Mailing Address - Country:US
Mailing Address - Phone:913-681-3500
Mailing Address - Fax:913-681-3501
Practice Address - Street 1:8024 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2116
Practice Address - Country:US
Practice Address - Phone:913-681-3500
Practice Address - Fax:913-681-3501
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05119111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor