Provider Demographics
NPI:1760659924
Name:KINNEY CHIROPRACTIC HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:KINNEY CHIROPRACTIC HEALTH CENTER, INC.
Other - Org Name:CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-383-3763
Mailing Address - Street 1:3955 GOVERNMENT ST
Mailing Address - Street 2:SUITE #8
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5755
Mailing Address - Country:US
Mailing Address - Phone:225-383-3763
Mailing Address - Fax:225-383-3767
Practice Address - Street 1:3955 GOVERNMENT ST
Practice Address - Street 2:SUITE #8
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-5755
Practice Address - Country:US
Practice Address - Phone:225-383-3763
Practice Address - Fax:225-383-3767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1950106Medicaid
LA1950106Medicaid