Provider Demographics
NPI:1780233197
Name:PHILLIPS CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:PHILLIPS CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:ROTHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-225-4139
Mailing Address - Street 1:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-1208
Mailing Address - Country:US
Mailing Address - Phone:620-227-1371
Mailing Address - Fax:202-225-4286
Practice Address - Street 1:2020 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-6411
Practice Address - Country:US
Practice Address - Phone:620-227-1371
Practice Address - Fax:620-225-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty