Provider Demographics
NPI:1275874885
Name:COHOON KINESIOLOGY CHIROPRACTIC AND REHAB LLC
Entity type:Organization
Organization Name:COHOON KINESIOLOGY CHIROPRACTIC AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TY
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:COHOON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-662-6160
Mailing Address - Street 1:3007 GARDEN GROVE PKWY
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-3907
Mailing Address - Country:US
Mailing Address - Phone:620-662-6160
Mailing Address - Fax:620-662-5223
Practice Address - Street 1:3007 GARDEN GROVE PKWY
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-3907
Practice Address - Country:US
Practice Address - Phone:620-662-6160
Practice Address - Fax:620-662-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04842261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center