Provider Demographics
NPI:1225023062
Name:JUNEMANN, KIMBERLY G (DC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:G
Last Name:JUNEMANN
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 1:2708 S W PARKWAY
Mailing Address - Street 2:SUITE A121
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-3733
Mailing Address - Country:US
Mailing Address - Phone:940-696-8184
Mailing Address - Fax:940-696-8187
Practice Address - Street 1:2708 S W PARKWAY
Practice Address - Street 2:SUITE A121
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-3733
Practice Address - Country:US
Practice Address - Phone:940-696-8184
Practice Address - Fax:940-696-8187
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AC950OtherBLUECROSS BLUESHIELD
TX8F21250Medicare PIN