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General NPI Number Information
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NPI Number | 1023282324
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE HEALTHCARE OF ST MARYS, PA.
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 513 W BERTRAND AVE
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City | ST. MARYS
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State | KS
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Zip | 66536-0236
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Country | US
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Telephone | 785-321-1700
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Fax | 785-321-1702
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Provider Business Mailing Address
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Address Line | 513 W BERTRAND AVE
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City | SAINT MARYS
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State | KS
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Zip | 66536-1658
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Country | US
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Telephone | 785-321-1700
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Fax | 785-321-1702
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JOHN MICHAEL WERTIN
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Credential | D.C.
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Telephone | 785-321-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | T05197
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License Number State | KS
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