Provider Demographics
NPI:1477733210
Name:KUTZTOWN FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KUTZTOWN FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABBIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-683-6400
Mailing Address - Street 1:635 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9745
Mailing Address - Country:US
Mailing Address - Phone:610-683-6400
Mailing Address - Fax:610-683-5603
Practice Address - Street 1:635 NOBLE ST
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9745
Practice Address - Country:US
Practice Address - Phone:610-683-6400
Practice Address - Fax:610-683-5603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty