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General NPI Number Information
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NPI Number | 1740796218
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Entity Type | Organization
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Legal Business Name | GAWITH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 2020 N WEBB RD STE 102
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City | WICHITA
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State | KS
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Zip | 67206-3408
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Country | US
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Telephone | 316-636-9393
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Fax | 316-636-9398
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Provider Business Mailing Address
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Address Line | 2020 N WEBB RD STE 102
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City | WICHITA
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State | KS
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Zip | 67206-3408
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Country | US
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Telephone | 316-636-9393
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Fax | 316-636-9398
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Authorized Official
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Title or Position | SOLE MBR
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Name | JAYME L GAWITH
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Credential | DC
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Telephone | 316-204-7603
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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 | 01-04820
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License Number State | KS
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