Provider Demographics
NPI:1790211258
Name:EXODUS HEALTH, L.L.C.
Entity type:Organization
Organization Name:EXODUS HEALTH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAILTEUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-213-5458
Mailing Address - Street 1:7410 SWITZER ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-4550
Mailing Address - Country:US
Mailing Address - Phone:913-962-7408
Mailing Address - Fax:913-962-7416
Practice Address - Street 1:7410 SWITZER ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4550
Practice Address - Country:US
Practice Address - Phone:913-962-7408
Practice Address - Fax:913-962-7416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty