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General NPI Number Information
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NPI Number | 1194094292
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Entity Type | Organization
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Legal Business Name | PHILLIPSBURG CHIROPRACTIC CENTER, PA
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 504 MAIN ST
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City | STOCKTON
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State | KS
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Zip | 67669-1932
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Country | US
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Telephone | 785-425-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 875 3RD ST
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City | PHILLIPSBURG
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State | KS
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Zip | 67661-1612
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Country | US
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Telephone | 785-543-2700
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Fax | 785-540-4041
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DUSTIN S CHENEY
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Credential | DC
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Telephone | 785-543-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 01-04824
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License Number State | KS
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