Provider Demographics
NPI:1720333834
Name:LOHAN CHIROPRACTIC AND ACUPUNCTURE CLINIC LLC
Entity Type:Organization
Organization Name:LOHAN CHIROPRACTIC AND ACUPUNCTURE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MI SUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-444-1218
Mailing Address - Street 1:404 E BANNISTER RD STE B
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3020
Mailing Address - Country:US
Mailing Address - Phone:816-444-1218
Mailing Address - Fax:866-291-2490
Practice Address - Street 1:404 E BANNISTER RD STE B
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-3020
Practice Address - Country:US
Practice Address - Phone:816-444-1218
Practice Address - Fax:866-291-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012016839111N00000X
KS01-05485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty