Provider Demographics
NPI:1811038623
Name:NON- SURGICAL SPINAL CARE OF WICHITA, INC
Entity Type:Organization
Organization Name:NON- SURGICAL SPINAL CARE OF WICHITA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:CODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-269-0470
Mailing Address - Street 1:3337 E CENTRAL AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3101
Mailing Address - Country:US
Mailing Address - Phone:316-269-0470
Mailing Address - Fax:954-568-0207
Practice Address - Street 1:1540 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-1143
Practice Address - Country:US
Practice Address - Phone:316-269-0470
Practice Address - Fax:954-568-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty