Provider Demographics
NPI:1063635878
Name:ACTIVE LIFE CHIROPRACTIC & ACUPUNCTURE P.A.
Entity Type:Organization
Organization Name:ACTIVE LIFE CHIROPRACTIC & ACUPUNCTURE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUEBLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-272-2020
Mailing Address - Street 1:120 SE 6TH AVE
Mailing Address - Street 2:STE. 105
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66603-3519
Mailing Address - Country:US
Mailing Address - Phone:785-272-2020
Mailing Address - Fax:
Practice Address - Street 1:120 SE 6TH AVE
Practice Address - Street 2:STE. 105
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3519
Practice Address - Country:US
Practice Address - Phone:785-272-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty