Provider Demographics
NPI:1780873364
Name:KITCHING CHIROPRACTIC
Entity type:Organization
Organization Name:KITCHING CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KITCHING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-681-2225
Mailing Address - Street 1:110 RUSHING LN
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-6027
Mailing Address - Country:US
Mailing Address - Phone:912-681-2225
Mailing Address - Fax:912-871-2225
Practice Address - Street 1:110 RUSHING LN
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6027
Practice Address - Country:US
Practice Address - Phone:912-681-2225
Practice Address - Fax:912-871-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO005332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3565Medicare PIN