Provider Demographics
NPI:1316195357
Name:DOPPS CHIROPRACTIC WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:DOPPS CHIROPRACTIC WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:DOPPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-945-8282
Mailing Address - Street 1:2243 S MERIDIAN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-1949
Mailing Address - Country:US
Mailing Address - Phone:316-945-8282
Mailing Address - Fax:316-945-2525
Practice Address - Street 1:2243 S MERIDIAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-1949
Practice Address - Country:US
Practice Address - Phone:316-945-8282
Practice Address - Fax:316-945-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS015057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty