Provider Demographics
NPI:1184825929
Name:GAWITH CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:GAWITH CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAWITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-636-9393
Mailing Address - Street 1:9390 E CENTRAL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2565
Mailing Address - Country:US
Mailing Address - Phone:316-636-9393
Mailing Address - Fax:316-636-9398
Practice Address - Street 1:9390 E CENTRAL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2565
Practice Address - Country:US
Practice Address - Phone:316-636-9393
Practice Address - Fax:316-636-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104820174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660118Medicare ID - Type Unspecified
KS=========Medicare UPIN