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Individual

MARY KATHERINE BISAHA SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
9209 W 110TH ST BLDG 36, OVERLAND PARK, KS 66210-1401
(913) 648-8111
(913) 912-5870
Mailing address
6299 W 157TH ST, OVERLAND PARK, KS 66223-3588
(816) 809-4126
(913) 912-5870

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04499
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13449020
BCBS
01
5107103
AETNA
Enumeration date
03/19/2007
Last updated
06/10/2014
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