MEDICARE: HALSTEAD CHIROPRACTIC CLINIC

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
1	111N00000X	Chiropractor	01-05051	KS

General Provider Information

NPI Number	:	1811091002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALSTEAD CHIROPRACTIC CLINIC

Provider Business Mailing Address
First Line	:	1423 REDBUD CT.
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056
Country	:	US
Telephone Number	:	316-835-2229
Fax Number	:	316-835-2304

Provider Business Practice Location Address
First Line	:	200 MAIN ST
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056
Country	:	US
Telephone Number	:	316-835-2229
Fax Number	:	316-835-2304

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. JARROD W PANZER
Credential	:	D.C.
Telephone Number	:	316-835-2229

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	08/22/2020

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