Healthcare Provider Details

I. General information

NPI: 1235200890
Provider Name (Legal Business Name): INTEGRITY CHIROPRACTIC AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13200 W 95TH ST
LENEXA KS
66215-3731
US

IV. Provider business mailing address

13200 W 95TH ST
LENEXA KS
66215-3731
US

V. Phone/Fax

Practice location:
  • Phone: 913-888-2066
  • Fax: 913-888-4851
Mailing address:
  • Phone: 913-888-2066
  • Fax: 913-888-4851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-04988
License Number StateKS

VIII. Authorized Official

Name: DR. FRANK A JIMENEZ II
Title or Position: SOLE MEMBER
Credential: DC
Phone: 913-888-2066