MEDICARE: ADVANCED HEALTH CENTER, P.A.

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
1	111N00000X	Chiropractor

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DN2494	OTHER	KS	RAILROAD MEDICARE
2	DN2494	OTHER	KS	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	660214	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1386816072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTH CENTER, P.A.

Provider Business Mailing Address
First Line	:	3017 W 6TH ST STE A
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-2364
Country	:	US
Telephone Number	:	785-841-2218
Fax Number	:

Provider Business Practice Location Address
First Line	:	3017 W 6TH ST STE A
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-2364
Country	:	US
Telephone Number	:	785-841-2218
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. MARC D. KISSINGER
Credential	:	D.C.
Telephone Number	:	785-841-2218

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	10/20/2008

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