Provider Demographics
NPI:1689864605
Name:KAB INC
Entity Type:Organization
Organization Name:KAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT KAB INC
Authorized Official - Prefix:
Authorized Official - First Name:KORIN (KORY)
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRANHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-268-8090
Mailing Address - Street 1:715 E 3900 S
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:801-268-8090
Mailing Address - Fax:801-268-8097
Practice Address - Street 1:715 E 3900 S
Practice Address - Street 2:SUITE 108
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-268-8090
Practice Address - Fax:801-268-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1659951202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty