Provider Demographics
NPI:1487835344
Name:LANE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:LANE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:COLBY
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-764-7722
Mailing Address - Street 1:407 S CLAIRBORNE RD
Mailing Address - Street 2:#201
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1723
Mailing Address - Country:US
Mailing Address - Phone:913-764-7722
Mailing Address - Fax:913-764-7723
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:#201
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1723
Practice Address - Country:US
Practice Address - Phone:913-764-7722
Practice Address - Fax:913-764-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS8466595OtherPTAN
TX2077660OtherAETNA
KS10675015OtherBLUE CROSS
MO10676013OtherBLUE CROSS GROUP
TX2077660OtherAETNA
KS8466595Medicare PIN