Provider Demographics
NPI:1447041959
Name:TABOR SPORTS & WELLNESS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:TABOR SPORTS & WELLNESS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TABOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-789-0126
Mailing Address - Street 1:11444 E CENTRAL AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2805
Mailing Address - Country:US
Mailing Address - Phone:316-241-9450
Mailing Address - Fax:316-330-3892
Practice Address - Street 1:11444 E CENTRAL AVE STE 202
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2805
Practice Address - Country:US
Practice Address - Phone:316-241-9450
Practice Address - Fax:316-330-3892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty