Provider Demographics
NPI:1437616588
Name:MOMENTUM CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:MOMENTUM CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERB
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BUTZBACH
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:913-461-9070
Mailing Address - Street 1:13078 S SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-9484
Mailing Address - Country:US
Mailing Address - Phone:913-461-9070
Mailing Address - Fax:
Practice Address - Street 1:463 S THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-2133
Practice Address - Country:US
Practice Address - Phone:913-461-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center