Provider Demographics
NPI:1508051707
Name:JENNINGS CHIROPRACTIC & KINESIOLOGY PA
Entity Type:Organization
Organization Name:JENNINGS CHIROPRACTIC & KINESIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-792-6854
Mailing Address - Street 1:1907 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-2425
Mailing Address - Country:US
Mailing Address - Phone:620-792-6854
Mailing Address - Fax:620-792-6841
Practice Address - Street 1:1907 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-2425
Practice Address - Country:US
Practice Address - Phone:620-792-6854
Practice Address - Fax:620-792-6841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty