Provider Demographics
NPI:1477678324
Name:LINDSEY, KENNETH RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:RAY
Last Name:LINDSEY
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:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:MORONGO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92256-1010
Mailing Address - Country:US
Mailing Address - Phone:760-327-6335
Mailing Address - Fax:760-327-6344
Practice Address - Street 1:777 N PALM CANYON DR
Practice Address - Street 2:STE 200
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5546
Practice Address - Country:US
Practice Address - Phone:760-327-6335
Practice Address - Fax:760-327-6344
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor