Provider Demographics
NPI:1205803319
Name:KASIAN, KENNETH E (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:E
Last Name:KASIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2974 N ALMA SCHOOL RD
Mailing Address - Street 2:STE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224
Mailing Address - Country:US
Mailing Address - Phone:480-821-7773
Mailing Address - Fax:480-821-7830
Practice Address - Street 1:2974 N ALMA SCHOOL RD
Practice Address - Street 2:STE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-821-7773
Practice Address - Fax:480-821-7830
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0233580OtherBLUE CROSS
4656790OtherAETNA
121345OtherHEALTHNET
AZ23073952OtherWORK COMP
T78864Medicare UPIN