Organization
ICON HEALTH & PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRICE WILTGEN DC (OWNER)
(913) 788-0291
Entity
Organization
Contact information
Practice address
26115 W VALLEY PKWY, OLATHE, KS 66061-7413
(913) 788-0291
Mailing address
14318 W 118TH CT, OLATHE, KS 66062-6574
(913) 788-0291
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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