Provider Demographics
NPI:1609586767
Name:BAYLESS CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BAYLESS CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MCKENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYLESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-413-9389
Mailing Address - Street 1:404 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:CANEY
Mailing Address - State:KS
Mailing Address - Zip Code:67333-2804
Mailing Address - Country:US
Mailing Address - Phone:605-413-9389
Mailing Address - Fax:
Practice Address - Street 1:110 N STATE ST
Practice Address - Street 2:
Practice Address - City:CANEY
Practice Address - State:KS
Practice Address - Zip Code:67333-1334
Practice Address - Country:US
Practice Address - Phone:605-413-9389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty