TONGANOXIE CHIROPRACTIC AND SOFT TISSUE REHAB (NPI# 1497029243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497029243 |
| Entity Type | Organization |
| Organization Name | TONGANOXIE CHIROPRACTIC AND SOFT TISSUE REHAB |
| Practice Address |
307 Ridge St Suite 104 Tonganoxie KS 66086-9304 |
| Practice Telephone | 9138459000 |
| Practice Fax Number | 9138453305 |
| Mailing Telephone | 9138459000 |
| Mailing Fax Number | 9138453305 |
| Enumeration Date | 2012-02-25 |
| Last Update Date | 2012-08-14 |
| Authorized Official Name | DR. GAVIN WADE OLDS (MANAGING MEMBER) |
| Authorized Official Telephone | 9138459000 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 01-05423 | KS | Chiropractic Providers |
| Street Address |
307 RIDGE ST SUITE 104 |
| City | TONGANOXIE |
| State | KS |
| Zip Code | 66086-9304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407981558 | Tonganoxie Chiropractic Clinic | Chiropractor | 307 Ridge St, Ste 104, Tonganoxie, KS 66086-9304 | 2007-02-22 |
| 1942580121 | Gavin Wade Olds | Chiropractor | 307 Ridge St, Suite 104, Tonganoxie, KS 66086-9304 | 2011-08-19 |
| 1447480231 | Back In Line Chiropractic LLC | Chiropractor | 307 Ridge St, Suite 104, Tonganoxie, KS 66086-9304 | 2009-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578798385 | Vintage Park At Tonganoxie, LLC | Assisted Living Facility | 120 W. 8th Street, Tonganoxie, KS 66086 | 2009-05-22 |
| 1629217336 | Jrr, Dds, LLC | Dentist | 504 E. 4th St., Tonganoxie, KS 66086 | 2009-02-19 |
| 1386768075 | Josh Adams | Specialist/Technologist | 2315 E. Sycamore St., Tonganoxie, KS 66086 | 2007-03-19 |
| 1144579558 | Physical Therapy Solutions LLC | Physical Therapist | 1198 Front St, Tonganoxie, KS 66086 | 2012-08-30 |
| 1255562542 | Karen Rogers | Case Manager/Care Coordinator | 304 West Street, Tonganoxie, KS 66086 | 2009-08-04 |
| 1285882878 | Chad Leever | Case Manager/Care Coordinator | 304 West Street, Tonganoxie, KS 66086 | 2008-09-08 |
| 1043544042 | Unified School District No. 464 | Clinic/Center | 330 East 24/40 Hwy, Tonganoxie, KS 66086-0199 | 2009-09-23 |
| 1770746521 | Susan Bozarth | Case Manager/Care Coordinator | 304 West Street, Tonganoxie, KS 66086-0252 | 2008-07-02 |
| 1699952713 | Carrie Koch | Case Manager/Care Coordinator | 304 West, Tonganoxie, KS 66086-0252 | 2008-01-31 |
| 1356575468 | Kristi L Pletcher | Case Manager/Care Coordinator | 304 West Street, Tonganoxie, KS 66086-0252 | 2009-05-05 |
| Find all providers in zip 66086 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942565064 | Matthew R Drake | Chiropractor | 22575 Tonganoxie Rd, Tonganoxie, KS 66086-4229 | 2012-07-05 |
| 1346370947 | Scott Dwight Ford | Chiropractor | 210 West St, Tonganoxie, KS 66086-8927 | 2007-03-06 |
| 1407981558 | Tonganoxie Chiropractic Clinic | Chiropractor | 307 Ridge St, Ste 104, Tonganoxie, KS 66086-9304 | 2007-02-22 |
| 1811908601 | James P Snyder | Chiropractor | 307 Ridge St Ste 104, Tonganoxie, KS 66086-9310 | 2006-08-10 |
| 1376549493 | Robert R. Schuck | Chiropractor | 1198 Front St, Tonganoxie, KS 66086-9707 | 2005-06-23 |
| 1942580121 | Gavin Wade Olds | Chiropractor | 307 Ridge St, Suite 104, Tonganoxie, KS 66086-9304 | 2011-08-19 |
| 1851603757 | Daniel George Haug | Chiropractor | 1198 Front St, Tonganoxie, KS 66086-9707 | 2010-07-08 |
| 1447480231 | Back In Line Chiropractic LLC | Chiropractor | 307 Ridge St, Suite 104, Tonganoxie, KS 66086-9304 | 2009-07-15 |
| 1760649610 | Midwest Chiropractic Center, Pa | Chiropractor | 1198 Front St, Tonganoxie, KS 66086-9707 | 2008-05-19 |
| 1992998397 | Samantha Lee Ford | Chiropractor | 210 West St, Tonganoxie, KS 66086-8927 | 2007-08-20 |
| Find all providers in TONGANOXIE | ||||
| City | TONGANOXIE |
| Zip Code | 66086 |
Please comment or provide details below to improve the information on TONGANOXIE CHIROPRACTIC AND SOFT TISSUE REHAB.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.