Provider Demographics
NPI:1598360869
Name:KINCADE INC
Entity Type:Organization
Organization Name:KINCADE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:STUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-419-7252
Mailing Address - Street 1:1918 BENTLEY CT
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-1311
Mailing Address - Country:US
Mailing Address - Phone:515-419-7252
Mailing Address - Fax:
Practice Address - Street 1:1830 SE PRINCETON DR STE D
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-4826
Practice Address - Country:US
Practice Address - Phone:515-419-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty