MEDICARE: DR. JEROME FRANCIS MANGEN 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
1	111N00000X	Chiropractor	01-03739	KS

General Provider Information

NPI Number	:	1508961186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROME FRANCIS MANGEN D.C.

Provider Business Mailing Address
First Line	:	2508 EDGEMONT DR
Second Line	:	SUITE 2
City	:	ARKANSAS CITY
State	:	KS
Zip	:	67005-3844
Country	:	US
Telephone Number	:	620-442-7120
Fax Number	:	620-442-7121

Provider Business Practice Location Address
First Line	:	2508 EDGEMONT DR
Second Line	:	SUITE 2
City	:	ARKANSAS CITY
State	:	KS
Zip	:	67005-3844
Country	:	US
Telephone Number	:	620-442-7120
Fax Number	:	620-442-7121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/06/2013

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