Provider Demographics
NPI:1356405666
Name:LORI KINDLE PA
Entity type:Organization
Organization Name:LORI KINDLE PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:D
Authorized Official - Last Name:KINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-495-4449
Mailing Address - Street 1:110 N FEDERAL HWY
Mailing Address - Street 2:608
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1180
Mailing Address - Country:US
Mailing Address - Phone:954-495-4449
Mailing Address - Fax:
Practice Address - Street 1:2382 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-2562
Practice Address - Country:US
Practice Address - Phone:954-495-4449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6326Medicare ID - Type UnspecifiedMEDICARE