Provider Demographics
NPI:1396182572
Name:WALDMAN WELLNESS AND CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:WALDMAN WELLNESS AND CHIROPRACTIC LLC
Other - Org Name:KEY DYNAMICS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-390-9355
Mailing Address - Street 1:153 W 151ST ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5348
Mailing Address - Country:US
Mailing Address - Phone:913-390-9355
Mailing Address - Fax:913-390-9356
Practice Address - Street 1:153 W 151ST ST
Practice Address - Street 2:SUITE 150
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5348
Practice Address - Country:US
Practice Address - Phone:913-390-9355
Practice Address - Fax:913-390-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05484261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center