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General NPI Number Information
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NPI Number | 1063600518
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE CHIROPRACTIC PA
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 2300 HUTTON RD SUITE 101
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City | KANSAS CITY
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State | KS
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Zip | 66109-4403
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Country | US
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Telephone | 913-721-0060
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Fax | 913-721-2553
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Provider Business Mailing Address
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Address Line | 2300 HUTTON RD SUITE 101
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City | KANSAS CITY
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State | KS
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Zip | 66109-4403
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Country | US
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Telephone | 913-721-0060
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Fax | 913-721-2553
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Authorized Official
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Title or Position | OWNER
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Name | DR. WENDY ANN BRILEY
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Credential | D.C.
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Telephone | 913-721-0060
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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 | 4742
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License Number State | KS
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