Provider Demographics
NPI:1013205012
Name:COULTER CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:COULTER CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-829-2225
Mailing Address - Street 1:15979 S BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3925
Mailing Address - Country:US
Mailing Address - Phone:913-829-2225
Mailing Address - Fax:913-829-2224
Practice Address - Street 1:15979 S BRADLEY DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3925
Practice Address - Country:US
Practice Address - Phone:913-829-2225
Practice Address - Fax:913-829-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty