Provider Demographics
NPI:1467951194
Name:KITE FAMILY CHIROPRACTIC PLC
Entity Type:Organization
Organization Name:KITE FAMILY CHIROPRACTIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:SVEND
Authorized Official - Last Name:KITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-243-7737
Mailing Address - Street 1:2105 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-2815
Mailing Address - Country:US
Mailing Address - Phone:712-254-1329
Mailing Address - Fax:
Practice Address - Street 1:1209 SUNNYSIDE LN
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-2203
Practice Address - Country:US
Practice Address - Phone:712-243-7737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1164875092Medicaid