Provider Demographics
NPI:1811483209
Name:GUNDLACH CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:GUNDLACH CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDLACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-443-3621
Mailing Address - Street 1:480 N FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-2326
Mailing Address - Country:US
Mailing Address - Phone:178-544-3362
Mailing Address - Fax:
Practice Address - Street 1:480 N FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2326
Practice Address - Country:US
Practice Address - Phone:178-544-3362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty