Provider Demographics
NPI:1770680720
Name:KINNEY, DAVID ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLEN
Last Name:KINNEY
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 1:3955 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
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1950106Medicaid
LA59397Medicare ID - Type Unspecified