Provider Demographics
NPI:1184689952
Name:FEIFER, KURT (DC)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:FEIFER
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 1:41810 N VENTURE DR
Mailing Address - Street 2:160 BUILDING E
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3169
Mailing Address - Country:US
Mailing Address - Phone:623-551-2447
Mailing Address - Fax:
Practice Address - Street 1:41810 N VENTURE DR
Practice Address - Street 2:160 BUILDING E
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3169
Practice Address - Country:US
Practice Address - Phone:623-551-2447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ100630Medicare ID - Type Unspecified