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NPI Code Detail

MEDICARE: SPECIFIC CHIROPRACTIC LLC

MEDICARE: SPECIFIC CHIROPRACTIC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor0104586KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127910022OTHERKSBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1568403426
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECIFIC CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 16010 METCALF AVE
Second Line : SUITE 200
City : STILWELL
State : KS
Zip : 66085-8973
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 16010 METCALF AVE
Second Line : SUITE 200
City : STILWELL
State : KS
Zip : 66085-8973
Country : US
Telephone Number : 913-239-0360
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BRIGITTE BRUNEAU
Credential :
Telephone Number : 913-239-0360
Provider Enumeration Date : 06/09/2006
Last Update Date : 08/22/2020

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Directions to “SPECIFIC CHIROPRACTIC LLC ” Practice Location

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