Provider Demographics
NPI:1760066153
Name:KOKOMO CHIROPRACTIC CARE, PC
Entity Type:Organization
Organization Name:KOKOMO CHIROPRACTIC CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:765-860-9522
Mailing Address - Street 1:1422 E CARTER ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4959
Mailing Address - Country:US
Mailing Address - Phone:765-860-9522
Mailing Address - Fax:
Practice Address - Street 1:824 BELVEDERE DR
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-5690
Practice Address - Country:US
Practice Address - Phone:765-860-9522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty