Provider Demographics
NPI:1861408528
Name:AUCHENBACH, COLLEEN GWYN (DC)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:GWYN
Last Name:AUCHENBACH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 BOB BILLINGS PKWY
Mailing Address - Street 2:STE 8
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049
Mailing Address - Country:US
Mailing Address - Phone:785-842-4181
Mailing Address - Fax:785-842-6436
Practice Address - Street 1:3300 BOB BILLINGS PKWY
Practice Address - Street 2:STE 8
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049
Practice Address - Country:US
Practice Address - Phone:785-842-4181
Practice Address - Fax:785-842-6436
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2508583OtherAETNA
KS27963013OtherBCBS
KS060104Medicare ID - Type Unspecified