Provider Demographics
NPI:1952555633
Name:KASHURBA, KENNETH JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:JOSEPH
Last Name:KASHURBA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HUMPHREY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4580
Mailing Address - Country:US
Mailing Address - Phone:724-853-2353
Mailing Address - Fax:724-853-2354
Practice Address - Street 1:245 HUMPHREY RD STE 2
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4580
Practice Address - Country:US
Practice Address - Phone:724-853-2353
Practice Address - Fax:724-853-2354
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-08
Last Update Date:2008-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002346L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor