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General NPI Number Information
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NPI Number | 1194071654
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Entity Type | Organization
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Legal Business Name | BEECH CHIROPRACTIC
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 9330 E CENTRAL AVE # SET300
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City | WICHITA
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State | KS
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Zip | 67206-2561
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Country | US
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Telephone | 316-655-6553
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Fax |
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Provider Business Mailing Address
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Address Line | 9330 E CENTRAL AVE #STE 300
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City | WICHITA
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State | KS
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Zip | 67206-2561
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Country | US
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Telephone | 316-655-6553
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER BEECH
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Credential | D.C
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Telephone | 316-655-6553
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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 | 01-05497
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License Number State | KS
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