Provider Demographics
NPI:1811184518
Name:KIRKLING CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:KIRKLING CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DON
Authorized Official - Last Name:KIRKLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-847-7429
Mailing Address - Street 1:2218 E STATE HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-9498
Mailing Address - Country:US
Mailing Address - Phone:812-847-7429
Mailing Address - Fax:812-847-0035
Practice Address - Street 1:2218 E STATE HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-9498
Practice Address - Country:US
Practice Address - Phone:812-847-7429
Practice Address - Fax:812-847-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000677A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10012410AMedicaid
INU02740Medicare UPIN
IN10012410AMedicaid