Healthcare Provider Details

I. General information

NPI: 1801009048
Provider Name (Legal Business Name): LORI KINDLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 EAST COMMERCIAL BLVD
FT LAUDERALE FL
33308
US

IV. Provider business mailing address

PO BOX 4367
FT LAUDERDALE FL
33338
US

V. Phone/Fax

Practice location:
  • Phone: 954-495-4255
  • Fax: 954-491-2296
Mailing address:
  • Phone: 954-495-4255
  • Fax: 954-491-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8333
License Number StateFL

VIII. Authorized Official

Name: DR. LORI D KINDLE
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 954-495-4255