Provider Demographics
NPI:1104215268
Name:DODSON CHIROPRACTIC
Entity Type:Organization
Organization Name:DODSON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-295-3730
Mailing Address - Street 1:2290 N TYLER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-8760
Mailing Address - Country:US
Mailing Address - Phone:316-295-3730
Mailing Address - Fax:
Practice Address - Street 1:2118 N TYLER RD STE 100B
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4912
Practice Address - Country:US
Practice Address - Phone:316-295-3730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-5652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty