Provider Demographics
NPI:1326314402
Name:KIEFER CORPORATION
Entity Type:Organization
Organization Name:KIEFER CORPORATION
Other - Org Name:ISLAND CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-924-3885
Mailing Address - Street 1:3900 CLARK RD STE C1
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2370
Mailing Address - Country:US
Mailing Address - Phone:941-924-3885
Mailing Address - Fax:
Practice Address - Street 1:3900 CLARK RD STE C1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2370
Practice Address - Country:US
Practice Address - Phone:941-924-3885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty