Provider Demographics
NPI:1114958105
Name:WINEINGER, KIMBERLY LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:LYNNE
Last Name:WINEINGER
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:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:MO
Mailing Address - Zip Code:65673-0617
Mailing Address - Country:US
Mailing Address - Phone:417-334-3688
Mailing Address - Fax:949-862-8323
Practice Address - Street 1:213 W. ATLANTIC ST.
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2423
Practice Address - Country:US
Practice Address - Phone:417-334-3688
Practice Address - Fax:949-862-8323
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC32199Medicare PIN
U61276Medicare UPIN