Provider Demographics
NPI:1518160480
Name:CARY MINOR CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:CARY MINOR CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:DANE
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-365-2524
Mailing Address - Street 1:221 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-3252
Mailing Address - Country:US
Mailing Address - Phone:620-365-2524
Mailing Address - Fax:
Practice Address - Street 1:221 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3252
Practice Address - Country:US
Practice Address - Phone:620-365-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-5050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS693237OtherUNITED HEALTHCARE
KS62301OtherBLUE CROSS & SHIELD
KS6660157Medicare ID - Type UnspecifiedBLUE CROSS &SHIELD
KS693237OtherUNITED HEALTHCARE