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General NPI Number Information
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NPI Number | 1700164910
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Entity Type | Organization
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Legal Business Name | WEBER FAMILY CHIROPRACTIC CLINIC PA
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 241 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-4903
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Country | US
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Telephone | 316-652-7900
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Fax | 316-652-7901
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Provider Business Mailing Address
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Address Line | 241 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-4903
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Country | US
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Telephone | 316-652-7900
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Fax | 316-652-7901
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Authorized Official
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Title or Position | OWNER, CEO
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Name | DR. DUSTIN L WEBER
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Credential | DC
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Telephone | 316-652-7900
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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 | 0105375
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License Number State | KS
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