Provider Demographics
NPI:1730122722
Name:BRANCH, KENNETH (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:BRANCH
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 1:790B SMOKEY PARK HWY
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9658
Mailing Address - Country:US
Mailing Address - Phone:828-670-6440
Mailing Address - Fax:
Practice Address - Street 1:790B SMOKEY PARK HWY
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9658
Practice Address - Country:US
Practice Address - Phone:828-670-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0827COtherBCBS PIN
NC890827CMedicaid
NC0827COtherBCBS PIN
NCT81621Medicare UPIN