Provider Demographics
NPI:1770629826
Name:XIONG, KAO (DC)
Entity Type:Individual
Prefix:DR
First Name:KAO
Middle Name:
Last Name:XIONG
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 1:10525 STONEBRIDGE TRL N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-9569
Mailing Address - Country:US
Mailing Address - Phone:651-214-5509
Mailing Address - Fax:
Practice Address - Street 1:1115 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-4923
Practice Address - Country:US
Practice Address - Phone:651-487-1821
Practice Address - Fax:651-489-0362
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor