Provider Demographics
NPI:1912205337
Name:WASINGER CHIROPRACTIC & ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:WASINGER CHIROPRACTIC & ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WASINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-300-1177
Mailing Address - Street 1:1811 E MARY ST
Mailing Address - Street 2:STE A1
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-3880
Mailing Address - Country:US
Mailing Address - Phone:214-300-1177
Mailing Address - Fax:
Practice Address - Street 1:1811 E MARY ST
Practice Address - Street 2:STE A1
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-3880
Practice Address - Country:US
Practice Address - Phone:214-300-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05352261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service