| |
7050 W 105th St, Overland Park, KS 66212-1803 | |
(913) 649-2044 | |
(913) 649-2064 |
Full Name | |
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Type | Facility |
Speciality | Acupuncturist |
Location | 7050 W 105th 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 |
---|---|---|---|
1235536988 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 01-05645 (Kansas) | Secondary |
171100000X | Acupuncturist | (* (Not Available)) | Primary |
Provider Name | Taejeon Shin |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1962757575 PECOS PAC ID: 5698091262 Enrollment ID: I20150226001575 |
Mailing Address | Practice Location Address |
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7050 W 105th St, Overland Park, KS 66212-1803 Ph: (913) 649-2044 | 7050 W 105th St, Overland Park, KS 66212-1803 Ph: (913) 649-2044 |