Provider Demographics
NPI:1770682759
Name:AUBURN HILLS CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:AUBURN HILLS CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:HOLDREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-721-2220
Mailing Address - Street 1:13605 W MAPLE ST
Mailing Address - Street 2:SUITE #105
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-8753
Mailing Address - Country:US
Mailing Address - Phone:316-721-2220
Mailing Address - Fax:316-721-2226
Practice Address - Street 1:13605 W MAPLE ST
Practice Address - Street 2:SUITE #105
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235-8753
Practice Address - Country:US
Practice Address - Phone:316-721-2220
Practice Address - Fax:316-721-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty