Provider Demographics
NPI:1033403498
Name:VIEREGGE, KENNETH L II (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:VIEREGGE
Suffix:II
Gender:M
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:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NC
Mailing Address - Zip Code:28509-0126
Mailing Address - Country:US
Mailing Address - Phone:252-745-0334
Mailing Address - Fax:252-745-2234
Practice Address - Street 1:13550 HWY 55 E
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NC
Practice Address - Zip Code:28509
Practice Address - Country:US
Practice Address - Phone:252-745-0334
Practice Address - Fax:252-745-2234
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor