Provider Demographics
NPI:1144852500
Name:TAICLET CHIROPRACTIC LLC
Entity type:Organization
Organization Name:TAICLET CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:TAICLET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-228-2946
Mailing Address - Street 1:219 W GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-1707
Mailing Address - Country:US
Mailing Address - Phone:620-365-3000
Mailing Address - Fax:620-365-3001
Practice Address - Street 1:219 W GARFIELD ST
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-1707
Practice Address - Country:US
Practice Address - Phone:620-365-3000
Practice Address - Fax:620-365-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty