Provider Demographics
NPI:1679082382
Name:ELLIOTT CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ELLIOTT CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABBEY
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-874-5472
Mailing Address - Street 1:112 S KANSAS AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-2147
Mailing Address - Country:US
Mailing Address - Phone:785-874-5472
Mailing Address - Fax:
Practice Address - Street 1:112 S KANSAS AVE STE 309
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-2147
Practice Address - Country:US
Practice Address - Phone:785-874-5472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty