Provider Demographics
NPI:1619076478
Name:ALL STAR CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ALL STAR CHIROPRACTIC, INC.
Other - Org Name:WESTWOOD CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-432-5678
Mailing Address - Street 1:4711 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1626
Mailing Address - Country:US
Mailing Address - Phone:913-432-5678
Mailing Address - Fax:913-236-8726
Practice Address - Street 1:4711 MISSION RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-1626
Practice Address - Country:US
Practice Address - Phone:913-432-5678
Practice Address - Fax:913-236-8726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT73603Medicare UPIN
KSW890000Medicare PIN