Provider Demographics
NPI:1306389598
Name:HEALING HANDS CHIROPRACTIC CENTER, PLLC
Entity Type:Organization
Organization Name:HEALING HANDS CHIROPRACTIC CENTER, PLLC
Other - Org Name:KINKAID FAMILY CHIROPRACTIC PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-869-8000
Mailing Address - Street 1:1873 WESTERN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5028
Mailing Address - Country:US
Mailing Address - Phone:518-869-8000
Mailing Address - Fax:
Practice Address - Street 1:1873 WESTERN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5028
Practice Address - Country:US
Practice Address - Phone:518-869-8000
Practice Address - Fax:518-869-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0128751302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
S2448797OtherBCBS