Healthcare Provider Details

I. General information

NPI: 1750631503
Provider Name (Legal Business Name): ASHLAND CHIROPRACTIC AND ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 MAIN STREET
ASHLAND KS
67831-0302
US

IV. Provider business mailing address

PO BOX 302
ASHLAND KS
67831-0302
US

V. Phone/Fax

Practice location:
  • Phone: 913-488-5923
  • Fax:
Mailing address:
  • Phone: 913-488-5923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number0105498
License Number StateKS

VIII. Authorized Official

Name: DR. DUSTIN COLE MCPHAIL
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 913-488-5923