Provider Demographics
NPI:1679907265
Name:WILBECK, TAYLOR AUSTIN (DC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:AUSTIN
Last Name:WILBECK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3743 N ROCK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1386
Mailing Address - Country:US
Mailing Address - Phone:316-500-8700
Mailing Address - Fax:316-559-8902
Practice Address - Street 1:3743 N ROCK RD STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1386
Practice Address - Country:US
Practice Address - Phone:316-500-8700
Practice Address - Fax:316-559-8902
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor