Provider Demographics
NPI:1063598407
Name:WICHITA KINESIOLOGY GROUP P.A..
Entity type:Organization
Organization Name:WICHITA KINESIOLOGY GROUP P.A..
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-684-0550
Mailing Address - Street 1:5205 E KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1634
Mailing Address - Country:US
Mailing Address - Phone:316-684-0550
Mailing Address - Fax:316-684-6596
Practice Address - Street 1:5205 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1634
Practice Address - Country:US
Practice Address - Phone:316-684-0550
Practice Address - Fax:316-684-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105556111N00000X
KSC-3525111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty