Provider Demographics
NPI:1083921092
Name:D'SOUZA, KENNETH KARLUS (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:KARLUS
Last Name:D'SOUZA
Suffix:
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 1:2342 COLONY CROSSING PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4280
Mailing Address - Country:US
Mailing Address - Phone:804-744-4317
Mailing Address - Fax:804-744-4318
Practice Address - Street 1:2342 COLONY CROSSING PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4280
Practice Address - Country:US
Practice Address - Phone:804-744-4317
Practice Address - Fax:804-744-4318
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13806111N00000X
VA0104556816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor