Provider Demographics
NPI:1902295462
Name:BABER, ANDREA JO (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JO
Last Name:BABER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:JO
Other - Last Name:SCHEUERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:805 ERA ST
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67871-1330
Mailing Address - Country:US
Mailing Address - Phone:620-214-0507
Mailing Address - Fax:620-909-5039
Practice Address - Street 1:920 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:KS
Practice Address - Zip Code:67871-1819
Practice Address - Country:US
Practice Address - Phone:620-872-3004
Practice Address - Fax:620-909-5039
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor