Provider Demographics
NPI:1265597173
Name:ROB CHIRO INC
Entity type:Organization
Organization Name:ROB CHIRO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-843-3979
Mailing Address - Street 1:3320 PETERSON RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-1738
Mailing Address - Country:US
Mailing Address - Phone:785-843-3979
Mailing Address - Fax:
Practice Address - Street 1:3320 PETERSON RD
Practice Address - Street 2:STE. 100
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-1738
Practice Address - Country:US
Practice Address - Phone:785-843-3979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-4177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS023853Medicare ID - Type UnspecifiedMEDICARE PROVIDER
KS1437269883OtherINDIVIDUAL PROVIDER NPI