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Individual

DR. BRETT MARTIN DWORKIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, CCSP

Contact information

Practice address
708 S ROGERS RD, SUITE A, OLATHE, KS 66062-1703
(913) 782-5000
(913) 782-5005
Mailing address
708 S. ROGERS RD., SUITE A, OLATHE, KS 66062
(913) 782-5000
(913) 782-5005

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
01-04631
KS
111NS0005X
Sports Physician Chiropractor
Primary
4631
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000B324
KANSAS MEDICARE P10
KS
01
20-0398766
TAX ID
KS
01
26604013
BCBS
KS
Enumeration date
02/20/2007
Last updated
03/12/2015
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