Provider Demographics
NPI:1326259086
Name:RESCO CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:RESCO CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RESCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-527-7000
Mailing Address - Street 1:1910 M ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66935-2207
Mailing Address - Country:US
Mailing Address - Phone:785-527-7000
Mailing Address - Fax:785-527-7001
Practice Address - Street 1:1910 M ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:KS
Practice Address - Zip Code:66935-2207
Practice Address - Country:US
Practice Address - Phone:785-527-7000
Practice Address - Fax:785-527-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660175OtherBCBS
KS660175Medicare PIN