Healthcare Provider Details

I. General information

NPI: 1255050035
Provider Name (Legal Business Name): KILKENNY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3592 ALOMA AVE STE 3
WINTER PARK FL
32792-4012
US

IV. Provider business mailing address

3592 ALOMA AVE STE 3
WINTER PARK FL
32792-4012
US

V. Phone/Fax

Practice location:
  • Phone: 407-706-1420
  • Fax: 407-673-4534
Mailing address:
  • Phone: 407-706-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH A WHOOLEY
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 407-706-1420