Provider Demographics
NPI:1295399335
Name:K D CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:K D CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:WITMER
Authorized Official - Last Name:DEIMLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-982-7196
Mailing Address - Street 1:223 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17074-1421
Mailing Address - Country:US
Mailing Address - Phone:717-567-3158
Mailing Address - Fax:
Practice Address - Street 1:223 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-1421
Practice Address - Country:US
Practice Address - Phone:717-567-3158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty