Organization
BOHANNON CHIROPRACTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL DOUGLAS BOHANNON DC (OWNER)
(316) 321-1667
Entity
Organization
Contact information
Practice address
1425 W CENTRAL, EL DORADO, KS 67042-2222
(316) 321-1667
(316) 321-1762
Mailing address
1425 W CENTRAL, EL DORADO, KS 67042-2222
(316) 321-1667
(888) 343-6040
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3679
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14222
BCBS
KS
Enumeration date
02/23/2007
Last updated
03/19/2013
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