Provider Demographics
NPI:1851465975
Name:IHRY, KEVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:IHRY
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 1:1411 32ND ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6304
Mailing Address - Country:US
Mailing Address - Phone:701-232-1232
Mailing Address - Fax:701-241-4175
Practice Address - Street 1:1411 32ND ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6304
Practice Address - Country:US
Practice Address - Phone:701-232-1232
Practice Address - Fax:701-241-4175
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND16551Medicaid
ND10489OtherBS ND PROVIDER NUMBER
NDU13728Medicare UPIN
ND16551Medicaid