Provider Demographics
NPI:1366594566
Name:RIVERSIDE CHIROPRACTIC PA
Entity type:Organization
Organization Name:RIVERSIDE CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:UEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-621-4747
Mailing Address - Street 1:1220 E. 27TH ST.
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2106
Mailing Address - Country:US
Mailing Address - Phone:785-621-4747
Mailing Address - Fax:785-621-4386
Practice Address - Street 1:1220 E. 27TH ST.
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2106
Practice Address - Country:US
Practice Address - Phone:785-621-4747
Practice Address - Fax:785-621-4386
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERSIDE CHIROPRACTIC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-17
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS48668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660071Medicare ID - Type UnspecifiedGROUP NO.