Provider Demographics
NPI:1700404035
Name:KUNEVICH CHIROPRACTIC AND ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:KUNEVICH CHIROPRACTIC AND ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:EDITH
Authorized Official - Last Name:KUNEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-520-1177
Mailing Address - Street 1:724 LUNCH RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62285-2544
Mailing Address - Country:US
Mailing Address - Phone:618-520-1177
Mailing Address - Fax:
Practice Address - Street 1:13 S MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:IL
Practice Address - Zip Code:62285-1705
Practice Address - Country:US
Practice Address - Phone:618-520-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty