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NPI Code Detail

MEDICARE: DR. KERRY J. O'NEILL DC

MEDICARE: DR. KERRY J. O'NEILL 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
1111N00000XChiropractorCH2928WA
2111N00000XChiropractorLA1189LA

General Provider Information

NPI Number : 1740344324
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KERRY J. O'NEILL DC
Provider Business Mailing Address
First Line : 203 14TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5223
Country : US
Telephone Number : 206-381-3473
Fax Number : 206-388-0913
Provider Business Practice Location Address
First Line : 203 14TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5223
Country : US
Telephone Number : 206-381-3473
Fax Number : 206-388-0913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/08/2007

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