Provider Demographics
NPI:1659308096
Name:KUNKEL, ABBIE L (DC)
Entity Type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:L
Last Name:KUNKEL
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 1:635 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9745
Mailing Address - Country:US
Mailing Address - Phone:610-683-6400
Mailing Address - Fax:610-683-5603
Practice Address - Street 1:635 NOBLE ST
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9745
Practice Address - Country:US
Practice Address - Phone:610-683-6400
Practice Address - Fax:610-683-5603
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097334Medicare ID - Type Unspecified