Provider Demographics
NPI:1689626434
Name:KIEFER, CHRIS M (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:M
Last Name:KIEFER
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 1:705 KANUGA RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-5229
Mailing Address - Country:US
Mailing Address - Phone:828-694-1121
Mailing Address - Fax:828-694-1116
Practice Address - Street 1:705 KANUGA ROAD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4962
Practice Address - Country:US
Practice Address - Phone:828-694-1121
Practice Address - Fax:828-694-1116
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085JUMedicaid
NC085JUOtherBLUE CROSS & BLUE SHIEL
NC2455439Medicare ID - Type Unspecified
NC89085JUMedicaid