Provider Demographics
NPI:1811979081
Name:KIN, MICHELE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:KIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18305
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27419-8305
Mailing Address - Country:US
Mailing Address - Phone:336-540-1040
Mailing Address - Fax:336-540-1041
Practice Address - Street 1:2608 A LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408
Practice Address - Country:US
Practice Address - Phone:336-540-1040
Practice Address - Fax:336-540-1041
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085RWMedicaid
NC89085RWMedicaid
V00696Medicare UPIN