Provider Demographics
NPI:1558525477
Name:PROCARE CHIROPRACTIC PA
Entity Type:Organization
Organization Name:PROCARE CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEYLOR-SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-393-1303
Mailing Address - Street 1:15211 S BLACKBOB RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3316
Mailing Address - Country:US
Mailing Address - Phone:913-393-1303
Mailing Address - Fax:913-393-1306
Practice Address - Street 1:15211 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3316
Practice Address - Country:US
Practice Address - Phone:913-393-1303
Practice Address - Fax:913-393-1306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5170305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS39871023OtherBCBSKC
KSKA1145Medicare UPIN