Provider Demographics
NPI:1699920785
Name:LERMA, MARCOS (DC)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:
Last Name:LERMA
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
Mailing Address - Street 2:102
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2700
Mailing Address - Country:US
Mailing Address - Phone:913-236-5030
Mailing Address - Fax:
Practice Address - Street 1:5830 WOODSON RD
Practice Address - Street 2:102
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2700
Practice Address - Country:US
Practice Address - Phone:913-236-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor