Provider Demographics
NPI:1275098121
Name:KC MOBILE HEALTH, LLC
Entity Type:Organization
Organization Name:KC MOBILE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-325-0720
Mailing Address - Street 1:535 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-4074
Mailing Address - Country:US
Mailing Address - Phone:913-325-0720
Mailing Address - Fax:913-335-0575
Practice Address - Street 1:535 W ELM ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-4074
Practice Address - Country:US
Practice Address - Phone:913-325-0720
Practice Address - Fax:913-335-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1720433444OtherDR. NICOLAS RODRIGUEZ NPI NUMBER