Provider Demographics
NPI:1821317207
Name:KOKORO II LTD
Entity Type:Organization
Organization Name:KOKORO II LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:FUJINAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-442-1336
Mailing Address - Street 1:PO BOX 12616
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86304-2616
Mailing Address - Country:US
Mailing Address - Phone:928-442-1336
Mailing Address - Fax:928-541-9518
Practice Address - Street 1:1680 OAKLAWN DR
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1108
Practice Address - Country:US
Practice Address - Phone:928-442-1336
Practice Address - Fax:928-541-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty