Provider Demographics
NPI:1114989423
Name:CHIRO-TECHNOLOGY PC
Entity Type:Organization
Organization Name:CHIRO-TECHNOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-694-4972
Mailing Address - Street 1:2385 DELHI COMMERCE DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-2192
Mailing Address - Country:US
Mailing Address - Phone:517-694-4972
Mailing Address - Fax:517-694-5898
Practice Address - Street 1:2385 DELHI COMMERCE DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-2192
Practice Address - Country:US
Practice Address - Phone:517-694-4972
Practice Address - Fax:517-694-5898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIX24786Medicare UPIN
MIOM49230Medicare UPIN