Provider Demographics
NPI:1336984137
Name:WALLPE CHIROPRACTIC RESTORATION LLC
Entity type:Organization
Organization Name:WALLPE CHIROPRACTIC RESTORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-324-2205
Mailing Address - Street 1:1562 E WICHITA AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KS
Mailing Address - Zip Code:67665-2461
Mailing Address - Country:US
Mailing Address - Phone:812-593-8600
Mailing Address - Fax:
Practice Address - Street 1:129 W 8TH ST STE A
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-1961
Practice Address - Country:US
Practice Address - Phone:785-324-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty