Provider Demographics
NPI:1497478903
Name:ALL SPINE CHIROPRACTIC AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ALL SPINE CHIROPRACTIC AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-617-7348
Mailing Address - Street 1:5931 NIEMAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2904
Mailing Address - Country:US
Mailing Address - Phone:913-914-7090
Mailing Address - Fax:913-391-6565
Practice Address - Street 1:5931 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2931
Practice Address - Country:US
Practice Address - Phone:316-617-7348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS01-05964OtherKANSAS BOARD OF HEALING ARTS