MEDICARE: KI ANN NORTHCUTT 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	DC-05514	OH

General Provider Information

NPI Number	:	1942167671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KI ANN NORTHCUTT DC

Provider Business Mailing Address
First Line	:	6177 LAKE ST
Second Line	:
City	:	KINGSVILLE
State	:	OH
Zip	:	44048-9703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6177 LAKE ST
Second Line	:
City	:	KINGSVILLE
State	:	OH
Zip	:	44048-9703
Country	:	US
Telephone Number	:	440-224-0680
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ KI ANN NORTHCUTT DC” Practice Location

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