Organization
SPECIFIC CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIGITTE BRUNEAU (OWNER)
(913) 239-0360
Entity
Organization
Contact information
Practice address
16010 METCALF AVE, SUITE 200, STILWELL, KS 66085-8973
(913) 239-0360
Mailing address
16010 METCALF AVE, SUITE 200, STILWELL, KS 66085-8973
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104586
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27910022
BLUE CROSS BLUE SHIELD
KS
Enumeration date
06/09/2006
Last updated
08/22/2020
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