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General NPI Number Information
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NPI Number | 1780836601
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH AND WELLNESS CENTER, L.L.C.
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 1319 E 1ST ST
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City | MCPHERSON
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State | KS
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Zip | 67460-3601
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Country | US
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Telephone | 620-504-6344
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Fax | 866-544-7606
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Provider Business Mailing Address
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Address Line | 1319 E 1ST ST
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City | MCPHERSON
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State | KS
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Zip | 67460-3601
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Country | US
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Telephone | 620-504-6344
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Fax | 866-544-7606
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. BRANDON GALE TROST
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Credential | D.C.
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Telephone | 620-504-6344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01-04626
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License Number State | KS
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