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General NPI Number Information
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NPI Number | 1629461777
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Entity Type | Organization
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Legal Business Name | GLACIAL HILLS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 1100 COLUMBINE DR SUITE E
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City | HOLTON
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State | KS
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Zip | 66436-8841
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Country | US
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Telephone | 785-364-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 11668 234TH LN
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City | HOLTON
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State | KS
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Zip | 66436-8390
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Country | US
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Telephone | 785-364-2252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY M WARNER
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Credential | D.C.
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Telephone | 785-364-2252
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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 | 01-04901
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License Number State | KS
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