Provider Demographics
NPI:1386850329
Name:CONSIGLI CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:CONSIGLI CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:CONSIGLI-WEGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-776-1850
Mailing Address - Street 1:1325 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-4002
Mailing Address - Country:US
Mailing Address - Phone:785-776-1850
Mailing Address - Fax:
Practice Address - Street 1:1325 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4002
Practice Address - Country:US
Practice Address - Phone:785-776-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS023536Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE
KST77149Medicare UPIN
KS023535Medicare ID - Type UnspecifiedGROUP MEDICARE