Provider Demographics
NPI:1831439611
Name:KENDELLE KRAUSE, D.C., P.C.
Entity type:Organization
Organization Name:KENDELLE KRAUSE, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-290-0256
Mailing Address - Street 1:16572 WASHINGTON ST.
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80023
Mailing Address - Country:US
Mailing Address - Phone:720-872-3724
Mailing Address - Fax:
Practice Address - Street 1:16572 WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80023
Practice Address - Country:US
Practice Address - Phone:720-872-3724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty