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General NPI Number Information
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NPI Number | 1750643433
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Entity Type | Organization
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Legal Business Name | WALTERS CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 2011 E CROSSROADS LN SUITE 302
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City | OLATHE
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State | KS
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Zip | 66062-1674
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Country | US
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Telephone | 913-738-7667
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 E CROSSROADS LN SUITE 302
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City | OLATHE
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State | KS
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Zip | 66062-1674
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Country | US
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Telephone | 913-738-7667
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Fax |
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Authorized Official
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Title or Position | OWNER/ CHIROPRACTOR
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Name | DR. JUSTIN R WALTERS
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Credential | D.C.
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Telephone | 913-738-7667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | T03149
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License Number State | KS
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