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General NPI Number Information
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NPI Number | 1174137319
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Entity Type | Organization
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Legal Business Name | INFINITE POTENTIAL CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 11963 E ANDRE DR
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City | GRAND LEDGE
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State | MI
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Zip | 48837-2189
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Country | US
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Telephone | 517-388-4976
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Fax |
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Provider Business Mailing Address
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Address Line | 11963 E ANDRE DR
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City | GRAND LEDGE
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State | MI
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Zip | 48837-2189
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Country | US
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Telephone | 517-388-4976
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. KATHLEEN KENNY
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Credential | D.C.
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Telephone | 517-388-4976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number |
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License Number State |
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