Provider Demographics
NPI:1316508351
Name:MIDWEST MUSCLE & JOINT CLINIC LLC
Entity type:Organization
Organization Name:MIDWEST MUSCLE & JOINT CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DRAKE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KAYSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-580-7272
Mailing Address - Street 1:3320 PETERSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-1739
Mailing Address - Country:US
Mailing Address - Phone:785-856-2273
Mailing Address - Fax:785-409-6225
Practice Address - Street 1:3320 PETERSON RD STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-1739
Practice Address - Country:US
Practice Address - Phone:785-856-2273
Practice Address - Fax:785-409-6225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty