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General NPI Number Information
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NPI Number | 1487963138
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Entity Type | Organization
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Legal Business Name | ENGELKEN CHIROPRACTIC
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 2730 N AMIDON AVE SUITE A
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City | WICHITA
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State | KS
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Zip | 67204-4952
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Country | US
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Telephone | 316-440-6888
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Fax | 316-440-6288
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Provider Business Mailing Address
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Address Line | 2730 N AMIDON AVE SUITE A
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City | WICHITA
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State | KS
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Zip | 67204-4952
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Country | US
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Telephone | 316-440-6888
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Fax | 316-440-6288
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Authorized Official
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Title or Position | OWNER/PRESIDENT/CHIROPRACTOR
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Name | DR. DAVE L ENGELKEN
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Credential | DC
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Telephone | 316-440-6888
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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 | 01-05340
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License Number State | KS
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