Provider Demographics
NPI:1508571548
Name:KIDERLEN, KATHARINA MAGDALENA (DC)
Entity Type:Individual
Prefix:
First Name:KATHARINA
Middle Name:MAGDALENA
Last Name:KIDERLEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 S. ARLINGTON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-3799
Mailing Address - Country:US
Mailing Address - Phone:330-896-2030
Mailing Address - Fax:330-899-0527
Practice Address - Street 1:3661 S. ARLINGTON RD
Practice Address - Street 2:STE 100
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-3799
Practice Address - Country:US
Practice Address - Phone:330-896-2030
Practice Address - Fax:330-899-0527
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor