Provider Demographics
NPI:1588946313
Name:AC CHIROPRACTIC & ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:AC CHIROPRACTIC & ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:913-764-2268
Mailing Address - Street 1:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:RANTOUL
Mailing Address - State:KS
Mailing Address - Zip Code:66079-0109
Mailing Address - Country:US
Mailing Address - Phone:913-764-2268
Mailing Address - Fax:913-273-0839
Practice Address - Street 1:1467 E 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2854
Practice Address - Country:US
Practice Address - Phone:913-764-2268
Practice Address - Fax:913-273-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty