Healthcare Provider Details

I. General information

NPI: 1811001795
Provider Name (Legal Business Name): KISLING FAMILY CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 CASS ST
TRAVERSE CITY MI
49684-4146
US

IV. Provider business mailing address

PO BOX 6711
TRAVERSE CITY MI
49696-6711
US

V. Phone/Fax

Practice location:
  • Phone: 231-946-2222
  • Fax:
Mailing address:
  • Phone: 231-946-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number2301007338
License Number StateMI

VIII. Authorized Official

Name: DR. ROBERT JEFFERSON KISLING
Title or Position: CEO/ CLINIC DIRECTOR
Credential: D.C.
Phone: 231-946-2222