Provider Demographics
NPI:1770269052
Name:KAISER CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:KAISER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING/BILLING/AC
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-939-7531
Mailing Address - Street 1:25521 E PAINTER RD
Mailing Address - Street 2:
Mailing Address - City:LATAH
Mailing Address - State:WA
Mailing Address - Zip Code:99018-9535
Mailing Address - Country:US
Mailing Address - Phone:509-939-7531
Mailing Address - Fax:
Practice Address - Street 1:624 W HASTINGS RD STE 8
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2877
Practice Address - Country:US
Practice Address - Phone:509-866-8056
Practice Address - Fax:509-290-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty