Provider Demographics
NPI:1043478746
Name:MILLS CHIROPRACTIC & WELLNESS CENTER, P.A.
Entity Type:Organization
Organization Name:MILLS CHIROPRACTIC & WELLNESS CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-764-5300
Mailing Address - Street 1:601 N MUR LEN RD
Mailing Address - Street 2:STE. 19
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5415
Mailing Address - Country:US
Mailing Address - Phone:913-764-5900
Mailing Address - Fax:
Practice Address - Street 1:601 N MUR LEN RD
Practice Address - Street 2:STE. 19
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5415
Practice Address - Country:US
Practice Address - Phone:913-764-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS35347017OtherBLUE CROSS BLUE SHIELD OF KC
KS35347017OtherBLUE CROSS BLUE SHIELD OF KC