Provider Demographics
NPI:1548812050
Name:MCNARY, DERECK JASPER (DC)
Entity type:Individual
Prefix:MR
First Name:DERECK
Middle Name:JASPER
Last Name:MCNARY
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 1:404 HUMBOLDT ST STE C
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6072
Mailing Address - Country:US
Mailing Address - Phone:785-477-4389
Mailing Address - Fax:
Practice Address - Street 1:404 HUMBOLDT ST STE C
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6072
Practice Address - Country:US
Practice Address - Phone:785-477-4389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05988111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor