Provider Demographics
NPI:1891142139
Name:GARLACH, JEFFREY HARTFORD (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HARTFORD
Last Name:GARLACH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7030 W CHILDS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-8613
Mailing Address - Country:US
Mailing Address - Phone:913-235-0708
Mailing Address - Fax:316-944-3535
Practice Address - Street 1:7130 W MAPLE ST STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2101
Practice Address - Country:US
Practice Address - Phone:316-944-2020
Practice Address - Fax:316-944-3535
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor