Provider Demographics
NPI:1396435558
Name:KIEHART CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:KIEHART CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:KIEHART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-267-8327
Mailing Address - Street 1:2757 LOWER LAKE RD APT B
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-9429
Mailing Address - Country:US
Mailing Address - Phone:570-267-8327
Mailing Address - Fax:
Practice Address - Street 1:228 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865-9517
Practice Address - Country:US
Practice Address - Phone:732-343-0318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty