Provider Demographics
NPI:1619024445
Name:KINSMAN, JOHN G (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:KINSMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:97 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-1733
Mailing Address - Country:US
Mailing Address - Phone:978-369-3806
Mailing Address - Fax:978-369-3993
Practice Address - Street 1:97 LOWELL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-1733
Practice Address - Country:US
Practice Address - Phone:978-369-3806
Practice Address - Fax:978-369-3993
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35361OtherHARVARD PILGRAM
MAY35517OtherBCBS OF MASS
MA713661OtherTUFTS HEALTH PLAN
MA713661OtherTUFTS HEALTH PLAN