Provider Demographics
NPI:1326247578
Name:JOHN M. WERTIN, D.C., P.A.
Entity Type:Organization
Organization Name:JOHN M. WERTIN, D.C., P.A.
Other - Org Name:ALTERNATIVE HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-537-9330
Mailing Address - Street 1:115 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-3328
Mailing Address - Country:US
Mailing Address - Phone:785-632-2053
Mailing Address - Fax:785-632-2083
Practice Address - Street 1:115 6TH ST
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432-3328
Practice Address - Country:US
Practice Address - Phone:785-632-2053
Practice Address - Fax:785-632-2083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN M. WERTIN, D.C., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU73583Medicare UPIN