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General NPI Number Information
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NPI Number | 1124317706
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Entity Type | Organization
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Legal Business Name | KENNELL FAMILY CHIROPRACTIC PA
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 115 HWY 46 WEST
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City | BOERNE
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State | TX
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Zip | 78006-2842
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Country | US
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Telephone | 830-249-8900
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Fax | 830-249-8923
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Provider Business Mailing Address
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Address Line | 215 W BANDERA RD STE 114 PMB 406
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City | BOERNE
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State | TX
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Zip | 78006-2842
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Country | US
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Telephone | 830-249-8900
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Fax | 830-249-8923
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES F KENNELL
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Credential | DC
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Telephone | 830-249-8900
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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 | TX 8054
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License Number State | TX
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