Provider Demographics
NPI:1972721603
Name:WICHITA CHIROPRACTIC INC.
Entity type:Organization
Organization Name:WICHITA CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:FARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-773-3178
Mailing Address - Street 1:10312 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3135
Mailing Address - Country:US
Mailing Address - Phone:316-773-3178
Mailing Address - Fax:316-722-6700
Practice Address - Street 1:10312 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3135
Practice Address - Country:US
Practice Address - Phone:316-773-3178
Practice Address - Fax:316-722-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-4099111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS60937OtherBCBS PROVIDER NUMBER
KSU37362Medicare UPIN
KS60937OtherBCBS PROVIDER NUMBER