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General NPI Number Information
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NPI Number | 1053675967
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Entity Type | Organization
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Legal Business Name | KINTOP INC
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 2425 TOWER AVE
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City | SUPERIOR
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State | WI
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Zip | 54880-4841
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Country | US
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Telephone | 715-392-3352
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Fax | 715-718-0669
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Provider Business Mailing Address
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Address Line | 2425 TOWER AVE
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City | SUPERIOR
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State | WI
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Zip | 54880-4841
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Country | US
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Telephone | 715-392-3352
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Fax | 715-718-0669
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS M KINTOP
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Credential | D.C.
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Telephone | 715-392-3352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2720012
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License Number State | WI
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