Provider Demographics
NPI:1609804863
Name:KUCHMANER, VICTOR ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:ANTHONY
Last Name:KUCHMANER
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 1:10922 S TRYON ST
Mailing Address - Street 2:STE B
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4152
Mailing Address - Country:US
Mailing Address - Phone:704-588-3433
Mailing Address - Fax:
Practice Address - Street 1:1570 S CANFIELD NILES RD
Practice Address - Street 2:BUILDING A, SUITE 103
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4077
Practice Address - Country:US
Practice Address - Phone:330-793-4445
Practice Address - Fax:330-793-1990
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000250416OtherANTHEM PROVIDER NUMBER
OH000000250416OtherANTHEM PROVIDER NUMBER