Provider Demographics
NPI:1225101462
Name:ADVANCED CHIROPRACTIC SERVICES PA
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-842-4181
Mailing Address - Street 1:1605 WAKARUSA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-1805
Mailing Address - Country:US
Mailing Address - Phone:785-842-4181
Mailing Address - Fax:785-842-6436
Practice Address - Street 1:1605 WAKARUSA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-1805
Practice Address - Country:US
Practice Address - Phone:785-842-4181
Practice Address - Fax:785-842-6436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS055009Medicare ID - Type Unspecified