Provider Demographics
NPI:1912147570
Name:WISNER, ARLEY MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ARLEY
Middle Name:MARIE
Last Name:WISNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ARLEY
Other - Middle Name:MARIE
Other - Last Name:POLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:11720 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-9395
Mailing Address - Country:US
Mailing Address - Phone:913-897-5485
Mailing Address - Fax:
Practice Address - Street 1:11720 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-9395
Practice Address - Country:US
Practice Address - Phone:913-897-5485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor