Provider Demographics
NPI:1235536988
Name:SHIN ACUPUNCTURE & CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:SHIN ACUPUNCTURE & CHIROPRACTIC, P.A.
Other - Org Name:KANSAS ACUPUNCTURE AND CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAEJEON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:913-742-2881
Mailing Address - Street 1:7050 W 105TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1803
Mailing Address - Country:US
Mailing Address - Phone:913-649-2044
Mailing Address - Fax:913-649-2064
Practice Address - Street 1:7050 W 105TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1803
Practice Address - Country:US
Practice Address - Phone:913-649-2044
Practice Address - Fax:913-649-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05645111N00000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty