Provider Demographics
NPI:1477504348
Name:DILLINGER CHIROPRACTIC CLINIC, PA
Entity Type:Organization
Organization Name:DILLINGER CHIROPRACTIC CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:DILLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-456-7167
Mailing Address - Street 1:426 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WAMEGO
Mailing Address - State:KS
Mailing Address - Zip Code:66547-1632
Mailing Address - Country:US
Mailing Address - Phone:785-456-7167
Mailing Address - Fax:785-456-6602
Practice Address - Street 1:426 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547-1632
Practice Address - Country:US
Practice Address - Phone:785-456-7167
Practice Address - Fax:785-456-6602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060820Medicare ID - Type Unspecified