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General NPI Number Information
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NPI Number | 1083972491
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Entity Type | Organization
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Legal Business Name | WILBECK INC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 418 N POPLAR ST
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City | SOUTH HUTCHINSON
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State | KS
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Zip | 67505-1210
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Country | US
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Telephone | 620-663-7733
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Fax | 620-662-5359
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Provider Business Mailing Address
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Address Line | 418 N POPLAR ST
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City | SOUTH HUTCHINSON
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State | KS
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Zip | 67505-1210
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Country | US
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Telephone | 620-663-7733
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Fax | 620-662-5359
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Authorized Official
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Title or Position | OWNER
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Name | DR. TONY A WILBECK
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Credential | D.C
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Telephone | 620-663-7733
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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 | C3715
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License Number State | KS
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