=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275631186
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER ALLEN KABLER D.C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2006
-----------------------------------------------------
Last Update Date | 12/06/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2290 N TYLER RD STE 100
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67205-8760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-721-3003
-----------------------------------------------------
Fax | 316-721-3001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14808 E SUNDANCE CT
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67230-7190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-721-3003
-----------------------------------------------------
Fax | 316-721-3001
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 01-04107
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------