Provider Demographics
NPI:1407981558
Name:TONGANOXIE CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:TONGANOXIE CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-845-9000
Mailing Address - Street 1:307 RIDGE ST
Mailing Address - Street 2:STE 104
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-9304
Mailing Address - Country:US
Mailing Address - Phone:913-845-9000
Mailing Address - Fax:913-845-9000
Practice Address - Street 1:307 RIDGE ST
Practice Address - Street 2:STE 104
Practice Address - City:TONGANOXIE
Practice Address - State:KS
Practice Address - Zip Code:66086-9304
Practice Address - Country:US
Practice Address - Phone:913-845-9000
Practice Address - Fax:913-845-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS007245OtherBCBS OF KANSAS