Provider Demographics
NPI:1902905094
Name:ROGERS, DALLIS DEON (DC)
Entity Type:Individual
Prefix:DR
First Name:DALLIS
Middle Name:DEON
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14331 METCALF AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2988
Mailing Address - Country:US
Mailing Address - Phone:913-685-0023
Mailing Address - Fax:913-685-0309
Practice Address - Street 1:14331 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2988
Practice Address - Country:US
Practice Address - Phone:913-685-0023
Practice Address - Fax:913-685-0309
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor