Provider Demographics
NPI:1750631503
Name:ASHLAND CHIROPRACTIC AND ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:ASHLAND CHIROPRACTIC AND ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:MCPHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-488-5923
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67831-0302
Mailing Address - Country:US
Mailing Address - Phone:913-488-5923
Mailing Address - Fax:
Practice Address - Street 1:811 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KS
Practice Address - Zip Code:67831-0302
Practice Address - Country:US
Practice Address - Phone:913-488-5923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105498111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty