Provider Demographics
NPI:1285683334
Name:KINSLEY, KRIS A (DC)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:A
Last Name:KINSLEY
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 1:551 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NY
Mailing Address - Zip Code:14892-1502
Mailing Address - Country:US
Mailing Address - Phone:607-565-9212
Mailing Address - Fax:
Practice Address - Street 1:551 BROAD ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NY
Practice Address - Zip Code:14892-1502
Practice Address - Country:US
Practice Address - Phone:607-565-9212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXO04945-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor