MEDICARE: KAILA ALVAREZ DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	6746	MN
2	111N00000X	Chiropractor	5731	WI

General Provider Information

NPI Number	:	1134743792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAILA ALVAREZ DC

Provider Business Mailing Address
First Line	:	107 GRANDVIEW CT
Second Line	:
City	:	COLUMBUS
State	:	WI
Zip	:	53925-2329
Country	:	US
Telephone Number	:	920-344-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 GRANDVIEW CT
Second Line	:
City	:	COLUMBUS
State	:	WI
Zip	:	53925-2329
Country	:	US
Telephone Number	:	920-344-0119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2020
Last Update Date	:	04/16/2022

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Directions to “ KAILA ALVAREZ DC” Practice Location

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