Provider Demographics
NPI:1295959575
Name:AFFILIATED CHIROPRACTIC CARE OF KANSAS, INC
Entity type:Organization
Organization Name:AFFILIATED CHIROPRACTIC CARE OF KANSAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-733-2420
Mailing Address - Street 1:PO BOX 8748
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71910-8748
Mailing Address - Country:US
Mailing Address - Phone:316-733-2420
Mailing Address - Fax:316-733-2510
Practice Address - Street 1:2402 N VINEGATE CIR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-3652
Practice Address - Country:US
Practice Address - Phone:316-733-2420
Practice Address - Fax:316-733-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization