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General NPI Number Information
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NPI Number | 1376518811
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Entity Type | Organization
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Legal Business Name | ALPHACARE BACK AND NECK PAIN CENTER, PA
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2617 S SANTA FE AVE
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City | CHANUTE
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State | KS
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Zip | 66720-3206
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Country | US
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Telephone | 620-431-6513
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Fax | 620-431-6514
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Provider Business Mailing Address
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Address Line | 2617 S SANTA FE AVE
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City | CHANUTE
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State | KS
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Zip | 66720-3206
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Country | US
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Telephone | 620-431-6513
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Fax | 620-431-6514
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTTY BUNCH
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Credential | D.C.
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Telephone | 620-431-6513
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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 | KS3651
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License Number State | KS
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