Healthcare Provider Details

I. General information

NPI: 1386923373
Provider Name (Legal Business Name): SIMEON M KUIC D. C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BATTERY PARK AVENUE # 212-A
ASHEVILLE NC
28801-2715
US

IV. Provider business mailing address

11 ZONNA COURT
CANDLER NC
28715-8993
US

V. Phone/Fax

Practice location:
  • Phone: 828-216-4182
  • Fax:
Mailing address:
  • Phone: 828-216-4182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4088
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: