Provider Demographics
NPI:1427378942
Name:KINDER, BRIAN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DAVID
Last Name:KINDER
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 1:3237 W 73RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-2206
Mailing Address - Country:US
Mailing Address - Phone:918-520-9704
Mailing Address - Fax:
Practice Address - Street 1:3540 E 31ST ST
Practice Address - Street 2:STE 1
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-1500
Practice Address - Country:US
Practice Address - Phone:918-520-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor