Provider Demographics
NPI:1043212756
Name:LINDELL, KERRY (DC)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:LINDELL
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 1:603 CASTLE LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3118
Mailing Address - Country:US
Mailing Address - Phone:650-948-2186
Mailing Address - Fax:
Practice Address - Street 1:1411 W EL CAMINO REAL
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2405
Practice Address - Country:US
Practice Address - Phone:650-227-0440
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21039111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology