Provider Demographics
NPI:1982878286
Name:KIRCHNER CHIROPRACTIC CLINIC, PC
Entity Type:Organization
Organization Name:KIRCHNER CHIROPRACTIC CLINIC, PC
Other - Org Name:KIRCHNER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:KIRCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:660-727-3677
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:KAHOKA
Mailing Address - State:MO
Mailing Address - Zip Code:63445-0013
Mailing Address - Country:US
Mailing Address - Phone:660-727-3677
Mailing Address - Fax:660-727-2222
Practice Address - Street 1:374 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:KAHOKA
Practice Address - State:MO
Practice Address - Zip Code:63445-1453
Practice Address - Country:US
Practice Address - Phone:660-727-3677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002829111N00000X
MO2007031161111NI0900X
MO2006021033111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty