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General NPI Number Information
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NPI Number | 1295085256
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Entity Type | Organization
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Legal Business Name | KIGAWA CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 1251 W REDONDO BEACH BLVD SUITE 202
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City | GARDENA
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State | CA
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Zip | 90247-3456
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Country | US
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Telephone | 310-715-2770
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Fax |
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Provider Business Mailing Address
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Address Line | 1251 W REDONDO BEACH BLVD SUITE 202
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City | GARDENA
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State | CA
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Zip | 90247-3456
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Country | US
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Telephone | 310-715-2770
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHIE KIGAWA
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Credential | D.C.
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Telephone | 310-715-2770
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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 | DC31719
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License Number State | CA
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