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General NPI Number Information
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NPI Number | 1043472475
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Entity Type | Organization
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Legal Business Name | KEVIN E RAEF, DC, PA
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 402 15TH ST
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City | CANYON
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State | TX
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Zip | 79015-3839
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Country | US
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Telephone | 806-655-1108
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Fax | 806-655-1037
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Provider Business Mailing Address
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Address Line | 402 15TH ST
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City | CANYON
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State | TX
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Zip | 79015-3839
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Country | US
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Telephone | 806-655-1108
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Fax | 806-655-1037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVN E RAEF
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Credential | DC
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Telephone | 806-655-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | DC3059
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License Number State | TX
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