Healthcare Provider Details

I. General information

NPI: 1083710354
Provider Name (Legal Business Name): KUTY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6634 E ASTER DR
SCOTTSDALE AZ
85254-4549
US

IV. Provider business mailing address

6634 E ASTER DR
SCOTTSDALE AZ
85254-4549
US

V. Phone/Fax

Practice location:
  • Phone: 480-945-7800
  • Fax: 480-945-7805
Mailing address:
  • Phone: 480-945-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7653
License Number StateAZ

VIII. Authorized Official

Name: DR. JOLENE NICOLE KUTY
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 480-945-7800