Provider Demographics
NPI:1417384108
Name:KIRKENDALL CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:KIRKENDALL CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LENNON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-283-4355
Mailing Address - Street 1:131 W BLUE STARR DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-4226
Mailing Address - Country:US
Mailing Address - Phone:918-283-4355
Mailing Address - Fax:918-283-4357
Practice Address - Street 1:131 W BLUE STARR DR
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4226
Practice Address - Country:US
Practice Address - Phone:918-283-4355
Practice Address - Fax:918-283-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty