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General NPI Number Information
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NPI Number | 1205815750
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Entity Type | Individual
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Provider Name | KEVIN JOHN CLERICO D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 COFFEE RD SUITE R
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1208
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Country | US
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Telephone | 661-831-4407
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Fax | 661-831-4409
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Provider Business Mailing Address
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Address Line | 600 COFFEE RD
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1264
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Country | US
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Telephone | 661-831-4407
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Fax | 661-831-4409
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC0286440
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License Number State | CA
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