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503 E. Bertrand Ave, St Marys, KS 66536 | |
(785) 437-6162 | |
(785) 437-6197 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 503 E. Bertrand Ave, St Marys, 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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1275646382 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 4457 (Kansas) | Primary |
Provider Name | Gary E Cleveland |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1023121100 PECOS PAC ID: 5294732475 Enrollment ID: I20061031000542 |
Mailing Address | Practice Location Address |
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503 E. Bertrand Ave, St Marys, KS 66536 Ph: (785) 437-6162 | 503 E. Bertrand Ave, St Marys, KS 66536 Ph: (785) 437-6162 |