Provider Demographics
NPI:1265614010
Name:DECKER CHIROPRACTIC WALK-IN-CARE, PA
Entity type:Organization
Organization Name:DECKER CHIROPRACTIC WALK-IN-CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-829-5111
Mailing Address - Street 1:13025 S MUR LEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1230
Mailing Address - Country:US
Mailing Address - Phone:913-829-5111
Mailing Address - Fax:913-829-5179
Practice Address - Street 1:13025 S MUR LEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1230
Practice Address - Country:US
Practice Address - Phone:913-829-5111
Practice Address - Fax:913-829-5179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04124111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1740223288OtherNPI GROUP