Provider Demographics
NPI:1952839805
Name:KME CHIRO INC
Entity Type:Organization
Organization Name:KME CHIRO INC
Other - Org Name:KRISTIN M. KIDGELL D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDGELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-637-2957
Mailing Address - Street 1:3202 DR MARTIN LUTHER KING ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1202
Mailing Address - Country:US
Mailing Address - Phone:1727-637-2957
Mailing Address - Fax:
Practice Address - Street 1:3202 DR MARTIN LUTHER KING ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1202
Practice Address - Country:US
Practice Address - Phone:172-763-7295
Practice Address - Fax:727-637-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7937111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHZ055AOtherPTAN