Provider Demographics
NPI:1619146917
Name:KALE CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:KALE CHIROPRACTIC CLINIC, LLC
Other - Org Name:KALE CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:B.J.
Authorized Official - Middle Name:
Authorized Official - Last Name:KALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-574-4800
Mailing Address - Street 1:1121 PARK WEST BLVD
Mailing Address - Street 2:SUITE 144
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7122
Mailing Address - Country:US
Mailing Address - Phone:864-574-4800
Mailing Address - Fax:
Practice Address - Street 1:W. 4TH NORTH STREET
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29433
Practice Address - Country:US
Practice Address - Phone:843-851-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty