Provider Demographics
NPI:1811060304
Name:MEYLOR, JADE
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:MEYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7922 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2733
Mailing Address - Country:US
Mailing Address - Phone:913-227-0909
Mailing Address - Fax:913-227-0912
Practice Address - Street 1:7922 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:913-227-0909
Practice Address - Fax:913-227-0912
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST76E352Medicare ID - Type Unspecified