Provider Demographics
NPI:1063600229
Name:SAXON CHIROPRACTIC WELLNESS CENTER,LLC
Entity type:Organization
Organization Name:SAXON CHIROPRACTIC WELLNESS CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SAXON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-424-5083
Mailing Address - Street 1:117 E KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:KS
Mailing Address - Zip Code:67880-2125
Mailing Address - Country:US
Mailing Address - Phone:620-424-5083
Mailing Address - Fax:
Practice Address - Street 1:117 E KANSAS AVE
Practice Address - Street 2:
Practice Address - City:ULYSSES
Practice Address - State:KS
Practice Address - Zip Code:67880-2125
Practice Address - Country:US
Practice Address - Phone:620-424-5083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty