| Spinal Care Center, Inc | |
|
11960 W 119th St, Overland Park, KS 66213-2216 | |
| (913) 744-2973 | |
| Not Available |
| Full Name | Spinal Care Center, Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 11960 W 119th 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 |
|---|---|---|---|
| 1215139621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 02-4944 (Kansas) | Primary |
| Provider Name | Mark Charles Childress |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083726632 PECOS PAC ID: 3870517741 Enrollment ID: I20060118000558 |
| Mailing Address | Practice Location Address |
|---|---|
| Spinal Care Center, Inc 15283 W 147th Dr, Olathe, KS 66062-5002 Ph: (913) 397-8882 | Spinal Care Center, Inc 11960 W 119th St, Overland Park, KS 66213-2216 Ph: (913) 744-2973 |
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