Provider Demographics
NPI:1154485175
Name:DOPPS CHIROPRACTIC FAMILY WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:DOPPS CHIROPRACTIC FAMILY WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-478-2878
Mailing Address - Street 1:1690 W 140TH AVE N STE B
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:KS
Mailing Address - Zip Code:67106-8043
Mailing Address - Country:US
Mailing Address - Phone:620-478-2878
Mailing Address - Fax:620-478-2360
Practice Address - Street 1:1690 W 140TH AVE N STE B
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:KS
Practice Address - Zip Code:67106-8043
Practice Address - Country:US
Practice Address - Phone:620-478-2878
Practice Address - Fax:620-478-2360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660107Medicare PIN