Provider Demographics
NPI:1164875092
Name:KITE, PAUL S (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:KITE
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 1:2111 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1245
Mailing Address - Country:US
Mailing Address - Phone:402-345-7500
Mailing Address - Fax:402-345-5228
Practice Address - Street 1:2111 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1245
Practice Address - Country:US
Practice Address - Phone:402-345-7500
Practice Address - Fax:402-345-5228
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor