Provider Demographics
NPI:1093070898
Name:QUERY, KRISTIN (OMD, LIC AC)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:QUERY
Suffix:
Gender:F
Credentials:OMD, LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LYTTLETON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7315
Mailing Address - Country:US
Mailing Address - Phone:828-712-7789
Mailing Address - Fax:
Practice Address - Street 1:1950 MAYBANK HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2126
Practice Address - Country:US
Practice Address - Phone:828-712-7789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-08
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC442171100000X
SC143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist