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General NPI Number Information
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NPI Number | 1568598605
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Entity Type | Organization
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Legal Business Name | GILL CHIROPRACTIC AND ACUPUNCTURE PA
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 1722 N PLUM ST
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City | HUTCHINSON
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State | KS
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Zip | 67502-5501
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Country | US
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Telephone | 620-669-8000
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Fax | 620-669-8030
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Provider Business Mailing Address
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Address Line | 1722 N PLUM ST
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City | HUTCHINSON
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State | KS
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Zip | 67502-5501
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Country | US
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Telephone | 620-669-8000
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Fax | 620-669-8030
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACOB DWAIN GILL
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Credential | D.C.
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Telephone | 620-669-8000
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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 | 0104697
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License Number State | KS
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