Provider Demographics
NPI:1467873752
Name:K&G CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:K&G CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-234-5268
Mailing Address - Street 1:29 WARD ST # B
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3319
Mailing Address - Country:US
Mailing Address - Phone:954-234-5268
Mailing Address - Fax:
Practice Address - Street 1:29 WARD ST # B
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3319
Practice Address - Country:US
Practice Address - Phone:954-234-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty