Provider Demographics
NPI:1245319680
Name:KUIKEN, PAUL ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALLEN
Last Name:KUIKEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:OAUL
Other - Middle Name:ALLEN
Other - Last Name:KUIKEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:104 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431-1316
Mailing Address - Country:US
Mailing Address - Phone:218-927-6383
Mailing Address - Fax:218-927-4409
Practice Address - Street 1:104 4TH ST NW
Practice Address - Street 2:
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431-1316
Practice Address - Country:US
Practice Address - Phone:218-927-6383
Practice Address - Fax:218-927-4409
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1245319680Medicare NSC