Provider Demographics
NPI:1710368600
Name:RUNNELS CHIROPRACTIC NORTH LLC
Entity Type:Organization
Organization Name:RUNNELS CHIROPRACTIC NORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RUNNELS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-728-2374
Mailing Address - Street 1:15510 STATE AVE STE 10B
Mailing Address - Street 2:
Mailing Address - City:BASEHOR
Mailing Address - State:KS
Mailing Address - Zip Code:66007-7114
Mailing Address - Country:US
Mailing Address - Phone:913-728-2374
Mailing Address - Fax:913-728-2384
Practice Address - Street 1:15510 STATE AVE STE 10B
Practice Address - Street 2:
Practice Address - City:BASEHOR
Practice Address - State:KS
Practice Address - Zip Code:66007-7114
Practice Address - Country:US
Practice Address - Phone:913-728-2374
Practice Address - Fax:913-728-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty