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General NPI Number Information
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NPI Number | 1083809628
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Entity Type | Organization
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Legal Business Name | METTLING CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 1916 E 9TH AVE
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City | WINFIELD
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State | KS
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Zip | 67156-3210
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Country | US
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Telephone | 620-221-6325
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 623
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City | WINFIELD
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State | KS
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Zip | 67156-0623
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Country | US
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Telephone | 620-221-6325
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Fax | 620-221-6327
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOSHUA SHANE METTLING
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Credential | D.C.
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Telephone | 620-221-6325
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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 | 5100
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License Number State | KS
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