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General NPI Number Information
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NPI Number | 1194976316
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Entity Type | Organization
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Legal Business Name | DK ACUPUNCTURE AND CHIROPRACTIC CORP
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 880 S LAKESHORE WAY
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City | LAKE ALFRED
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State | FL
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Zip | 33850-3320
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Country | US
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Telephone | 863-956-9393
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Fax | 863-956-9393
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Provider Business Mailing Address
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Address Line | 2221 W CENTRAL AVE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-2455
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Country | US
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Telephone | 863-956-9393
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Fax | 863-956-9393
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID W KENEMUTH
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Credential | DC
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Telephone | 863-956-9393
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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 | CH001514
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License Number State | FL
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