Provider Demographics
NPI:1225081086
Name:HOUPT, KATHLEEN EVE AITA (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:EVE AITA
Last Name:HOUPT
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 1:80 BAYLOR DR STE 114
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-8905
Mailing Address - Country:US
Mailing Address - Phone:843-706-3472
Mailing Address - Fax:843-706-3473
Practice Address - Street 1:80 BAYLOR DR STE 114
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-8905
Practice Address - Country:US
Practice Address - Phone:843-706-3472
Practice Address - Fax:843-706-3473
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V01307Medicare UPIN
AA05967556Medicare ID - Type Unspecified