Provider Demographics
NPI:1659603827
Name:KANSAS CHIROPRACTIC & REHABILITATION, P.A.
Entity Type:Organization
Organization Name:KANSAS CHIROPRACTIC & REHABILITATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-367-1333
Mailing Address - Street 1:2331 ALABAMA ST
Mailing Address - Street 2:104
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-4446
Mailing Address - Country:US
Mailing Address - Phone:561-367-1333
Mailing Address - Fax:561-367-1320
Practice Address - Street 1:2331 ALABAMA ST
Practice Address - Street 2:104
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-4446
Practice Address - Country:US
Practice Address - Phone:561-367-1333
Practice Address - Fax:561-367-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00640111N00000X
KY01-05104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty