Provider Demographics
NPI:1356492391
Name:PICK CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:PICK CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:PICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-225-3411
Mailing Address - Street 1:2300 N 14TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2368
Mailing Address - Country:US
Mailing Address - Phone:620-225-3411
Mailing Address - Fax:
Practice Address - Street 1:2300 N 14TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2368
Practice Address - Country:US
Practice Address - Phone:620-225-3411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006116111NS0005X
KS01-03788111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty