Healthcare Provider Details

I. General information

NPI: 1497954648
Provider Name (Legal Business Name): JOHN M. WERTIN, D.C.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E MAIN ST STE 101
COUNCIL GROVE KS
66846-1355
US

IV. Provider business mailing address

501 E MAIN ST STE 101
COUNCIL GROVE KS
66846-1355
US

V. Phone/Fax

Practice location:
  • Phone: 620-767-5282
  • Fax: 620-767-5292
Mailing address:
  • Phone: 620-767-5282
  • Fax: 620-767-5292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-04653
License Number StateKS

VIII. Authorized Official

Name: MS. KATRINA H ROOKER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 785-537-9330