Provider Demographics
NPI:1477149136
Name:KKG CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KKG CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISHMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GULIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-891-4434
Mailing Address - Street 1:16585 NW 2ND AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16585 NW 2ND AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6038
Practice Address - Country:US
Practice Address - Phone:786-786-9598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty