Provider Demographics
NPI:1861685687
Name:GILKISON FAMILY CHIROPRACTIC P. C.
Entity Type:Organization
Organization Name:GILKISON FAMILY CHIROPRACTIC P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILKISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-554-7246
Mailing Address - Street 1:672 SE BAYBERRY LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4354
Mailing Address - Country:US
Mailing Address - Phone:816-554-7246
Mailing Address - Fax:816-554-1829
Practice Address - Street 1:672 SE BAYBERRY LN
Practice Address - Street 2:SUITE 105
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-4354
Practice Address - Country:US
Practice Address - Phone:816-554-7246
Practice Address - Fax:816-554-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001030193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty