Provider Demographics
NPI:1679757694
Name:DOUGLASS FAMILY CHIRPRACTIC, PA
Entity type:Organization
Organization Name:DOUGLASS FAMILY CHIRPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / SECRETARY / DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-746-2201
Mailing Address - Street 1:PO BOX 382
Mailing Address - Street 2:
Mailing Address - City:DOUGLASS
Mailing Address - State:KS
Mailing Address - Zip Code:67039-0382
Mailing Address - Country:US
Mailing Address - Phone:316-746-2201
Mailing Address - Fax:316-746-2245
Practice Address - Street 1:226 S. FORREST ST
Practice Address - Street 2:
Practice Address - City:DOUGLASS
Practice Address - State:KS
Practice Address - Zip Code:67039
Practice Address - Country:US
Practice Address - Phone:316-746-2201
Practice Address - Fax:316-746-2245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOUGLASS FAMILY CHIROPRACTIC, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7758111N00000X
KS01-05140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty