Provider Demographics
NPI:1205925062
Name:KAISER, MITCHEL B (DC)
Entity type:Individual
Prefix:DR
First Name:MITCHEL
Middle Name:B
Last Name:KAISER
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 1:761 COLONIAL ARMS RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7609
Mailing Address - Country:US
Mailing Address - Phone:908-577-7887
Mailing Address - Fax:
Practice Address - Street 1:761 COLONIAL ARMS RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7609
Practice Address - Country:US
Practice Address - Phone:908-577-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00632400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor