Provider Demographics
NPI:1467054726
Name:QUECK, KAIN TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:KAIN
Middle Name:TAYLOR
Last Name:QUECK
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 1:213 S OLD PACIFIC HWY
Mailing Address - Street 2:
Mailing Address - City:MYRTLE CREEK
Mailing Address - State:OR
Mailing Address - Zip Code:97457-8784
Mailing Address - Country:US
Mailing Address - Phone:541-860-3000
Mailing Address - Fax:
Practice Address - Street 1:213 S OLD PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE CREEK
Practice Address - State:OR
Practice Address - Zip Code:97457-8784
Practice Address - Country:US
Practice Address - Phone:541-860-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05010111N00000X
OR6146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty