Provider Demographics
NPI:1467892976
Name:CHIROPRACTIC HEALTH CENTER, LLC
Entity type:Organization
Organization Name:CHIROPRACTIC HEALTH CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIRPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:DANE
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-321-1771
Mailing Address - Street 1:4538 NW SHUMWAY RD STE B
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-8385
Mailing Address - Country:US
Mailing Address - Phone:620-752-3124
Mailing Address - Fax:
Practice Address - Street 1:4538 NW SHUMWAY RD
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-8385
Practice Address - Country:US
Practice Address - Phone:620-752-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104013111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty