MEDICARE: DR. GINGA ESTEE KIMBRO 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	2022037182	MO

General Provider Information

NPI Number	:	1417702531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GINGA ESTEE KIMBRO DC

Provider Business Mailing Address
First Line	:	1760 ABBEY RD STE 200-8551
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-7301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1760 ABBEY RD STE 200-8551
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-7301
Country	:	US
Telephone Number	:	989-295-7980
Fax Number	:

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

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	08/06/2025

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