| Chiropractic Treatment Center, Pa | |
|
11791 W 112th St, Suite 100, Overland Park, KS 66210-2761 | |
| (913) 888-3338 | |
| (913) 696-1908 |
| Full Name | Chiropractic Treatment Center, Pa |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Orthopedic |
| Location | 11791 W 112th St, Overland Park, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417161662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NX0800X | Chiropractor - Orthopedic | 01-03761 (Kansas) | Primary |
| Provider Name | Stephen Charles Gradwohl |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265523179 PECOS PAC ID: 5597797886 Enrollment ID: I20050908000795 |
| Provider Name | Amy J Bates |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1427359801 PECOS PAC ID: 4789873670 Enrollment ID: I20110107000280 |
| Mailing Address | Practice Location Address |
|---|---|
| Chiropractic Treatment Center, Pa 11791 W 112th St, Suite 100, Overland Park, KS 66210-2761 Ph: (913) 888-3338 | Chiropractic Treatment Center, Pa 11791 W 112th St, Suite 100, Overland Park, KS 66210-2761 Ph: (913) 888-3338 |
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