Provider Demographics
NPI:1811485386
Name:KC WELLNESS INSTITUTE PA
Entity type:Organization
Organization Name:KC WELLNESS INSTITUTE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COMMERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-307-0733
Mailing Address - Street 1:10628 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1651
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10628 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214
Practice Address - Country:US
Practice Address - Phone:913-307-0733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty