Provider Demographics
NPI:1225177124
Name:CENTRAL PLAINS RADIOLOGICAL SERVICES, P.A.
Entity Type:Organization
Organization Name:CENTRAL PLAINS RADIOLOGICAL SERVICES, P.A.
Other - Org Name:GOULD CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-542-3400
Mailing Address - Street 1:126 N MAIN
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:KS
Mailing Address - Zip Code:67025
Mailing Address - Country:US
Mailing Address - Phone:316-542-3400
Mailing Address - Fax:316-542-3404
Practice Address - Street 1:126 N. MAIN
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:KS
Practice Address - Zip Code:67025
Practice Address - Country:US
Practice Address - Phone:316-542-3400
Practice Address - Fax:316-542-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103953111N00000X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660046OtherBCBSKS
KS660046Medicare ID - Type Unspecified
KS660046OtherBCBSKS