Healthcare Provider Details

I. General information

NPI: 1316424856
Provider Name (Legal Business Name): THE CHIROPRACTIC CENTERS P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 3RD ST
PHILLIPSBURG KS
67661-1612
US

IV. Provider business mailing address

875 3RD ST
PHILLIPSBURG KS
67661-1612
US

V. Phone/Fax

Practice location:
  • Phone: 785-543-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: STATEN MCCLACHERTY
Title or Position: OWNER
Credential:
Phone: 785-543-2700