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General NPI Number Information
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NPI Number | 1912205337
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Entity Type | Organization
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Legal Business Name | WASINGER CHIROPRACTIC & ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 1811 E MARY ST STE A1
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City | GARDEN CITY
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State | KS
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Zip | 67846-3880
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Country | US
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Telephone | 214-300-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 E MARY ST STE A1
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City | GARDEN CITY
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State | KS
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Zip | 67846-3880
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Country | US
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Telephone | 214-300-1177
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BLAKE ANTHONY WASINGER
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Credential | D.C.
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Telephone | 214-300-1177
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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 | 01-05352
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License Number State | KS
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