| |
11879 W 112th St, Suite 100, Overland Park, KS 66210 | |
(913) 338-1112 | |
(913) 338-2079 |
Full Name | |
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Type | Facility |
Speciality | Physical Medicine & Rehabilitation |
Location | 11879 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 |
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1811314834 | NPI | - | NPPES |
Provider Name | Shirin M Gulledge |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1275676371 PECOS PAC ID: 2466558259 Enrollment ID: I20070511000337 |
Provider Name | David L Gulledge |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1992938369 PECOS PAC ID: 2769523018 Enrollment ID: I20100108000170 |
Provider Name | Kyle V Gulledge |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1336372887 PECOS PAC ID: 5395886642 Enrollment ID: I20100108000187 |
Mailing Address | Practice Location Address |
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11879 W 112th St, Suite 100, Overland Park, KS 66210 Ph: (913) 338-1112 | 11879 W 112th St, Suite 100, Overland Park, KS 66210 Ph: (913) 338-1112 |