Provider Demographics
NPI:1376796755
Name:PANZER CHIROPRACTIC CLINIC, P.A.
Entity Type:Organization
Organization Name:PANZER CHIROPRACTIC CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KODI
Authorized Official - Middle Name:N
Authorized Official - Last Name:PANZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-947-3157
Mailing Address - Street 1:122 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-1526
Mailing Address - Country:US
Mailing Address - Phone:620-947-3157
Mailing Address - Fax:620-947-2630
Practice Address - Street 1:122 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-1526
Practice Address - Country:US
Practice Address - Phone:620-947-3157
Practice Address - Fax:620-947-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00410686Medicare PIN
062352Medicare PIN
V1141Medicare UPIN