Healthcare Provider Details

I. General information

NPI: 1477504348
Provider Name (Legal Business Name): DILLINGER CHIROPRACTIC CLINIC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 LINCOLN ST
WAMEGO KS
66547-1632
US

IV. Provider business mailing address

426 LINCOLN ST
WAMEGO KS
66547-1632
US

V. Phone/Fax

Practice location:
  • Phone: 785-456-7167
  • Fax: 785-456-6602
Mailing address:
  • Phone: 785-456-7167
  • Fax: 785-456-6602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-04067
License Number StateKS

VIII. Authorized Official

Name: DR. KYLE T DILLINGER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 785-456-7167