Provider Demographics
NPI:1215234067
Name:EASTERN KANSAS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:EASTERN KANSAS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-695-4533
Mailing Address - Street 1:PO BOX 2425
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66201-2425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9353 W 75TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-4000
Practice Address - Country:US
Practice Address - Phone:816-695-4533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty