Provider Demographics
NPI:1821715558
Name:KS SPINE & PERFORMANCE LLC
Entity Type:Organization
Organization Name:KS SPINE & PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEWEIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-682-5149
Mailing Address - Street 1:104 N CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67834-3481
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 MILITARY AVE STE 222
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-4945
Practice Address - Country:US
Practice Address - Phone:620-682-5149
Practice Address - Fax:620-371-5637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty