Provider Demographics
NPI:1942396528
Name:YOUR WELLNESS CONNECTION, P.A.
Entity Type:Organization
Organization Name:YOUR WELLNESS CONNECTION, P.A.
Other - Org Name:ROBIN CHIROPRACTIC & ACUPUNCTURE CENTER, P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-962-7408
Mailing Address - Street 1:7410 SWITZER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-4550
Mailing Address - Country:US
Mailing Address - Phone:913-962-7408
Mailing Address - Fax:913-962-7416
Practice Address - Street 1:7410 SWITZER
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4550
Practice Address - Country:US
Practice Address - Phone:913-962-7408
Practice Address - Fax:913-962-7416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCG4192OtherRAILROAD MEDICARE
KSH480000Medicare PIN