Provider Demographics
NPI:1285021634
Name:K GROUP PC
Entity Type:Organization
Organization Name:K GROUP PC
Other - Org Name:KEYSTONE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARWILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-641-8353
Mailing Address - Street 1:602 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LANGDON
Mailing Address - State:ND
Mailing Address - Zip Code:58249-2622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:602 3RD ST
Practice Address - Street 2:
Practice Address - City:LANGDON
Practice Address - State:ND
Practice Address - Zip Code:58249-2622
Practice Address - Country:US
Practice Address - Phone:701-256-2720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty