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General NPI Number Information
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NPI Number | 1770682759
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Entity Type | Organization
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Legal Business Name | AUBURN HILLS CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 13605 W MAPLE ST SUITE #105
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City | WICHITA
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State | KS
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Zip | 67235-8753
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Country | US
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Telephone | 316-721-2220
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Fax | 316-721-2226
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Provider Business Mailing Address
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Address Line | 13605 W MAPLE ST SUITE #105
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City | WICHITA
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State | KS
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Zip | 67235-8753
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Country | US
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Telephone | 316-721-2220
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Fax | 316-721-2226
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACOB KYLE HOLDREN
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Credential | D.C.
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Telephone | 316-721-2220
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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 | 4871
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License Number State | KS
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