Healthcare Provider Details

I. General information

NPI: 1558368563
Provider Name (Legal Business Name): LORI D KINDLE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2382 N FEDERAL HWY
FT LAUDERDALE FL
33305-2562
US

IV. Provider business mailing address

110 N FEDERAL HWY 608
FT LAUDERDALE FL
33301-1180
US

V. Phone/Fax

Practice location:
  • Phone: 954-495-4449
  • Fax:
Mailing address:
  • Phone: 954-495-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: