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NPI Code Detail

MEDICARE: DR. GLEN ALLEN FITZNER D. C.

MEDICARE: DR. GLEN ALLEN FITZNER D. C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor03191KS

General Provider Information

NPI Number : 1356318877
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLEN ALLEN FITZNER D. C.
Provider Business Mailing Address
First Line : 3535 W CENTRAL AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-4921
Country : US
Telephone Number : 316-943-3208
Fax Number : 316-943-3209
Provider Business Practice Location Address
First Line : 3535 W CENTRAL AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-4921
Country : US
Telephone Number : 316-943-3208
Fax Number : 316-943-3209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 07/08/2007

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