MEDICARE: WASINGER CHIROPRACTIC & ACUPUNCTURE, LLC

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	261QH0100X	Health Service Clinic/Center	01-05352	KS

General Provider Information

NPI Number	:	1912205337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASINGER CHIROPRACTIC & ACUPUNCTURE, LLC

Provider Business Mailing Address
First Line	:	1811 E MARY ST
Second Line	:	STE A1
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-3880
Country	:	US
Telephone Number	:	214-300-1177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 E MARY ST
Second Line	:	STE A1
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-3880
Country	:	US
Telephone Number	:	214-300-1177
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BLAKE ANTHONY WASINGER
Credential	:	D.C.
Telephone Number	:	214-300-1177

Provider Enumeration Date	:	03/09/2011
Last Update Date	:	03/09/2011

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