Healthcare Provider Details

I. General information

NPI: 1184718298
Provider Name (Legal Business Name): KUZMA CHIROPRACTIC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 DIVISION ST E
BUFFALO MN
55313-1525
US

IV. Provider business mailing address

110 DIVISION ST E
BUFFALO MN
55313-1525
US

V. Phone/Fax

Practice location:
  • Phone: 763-682-1471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. THOMAS D KUZMA
Title or Position: OWNER
Credential: DC
Phone: 763-682-1471