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General NPI Number Information
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NPI Number | 1356466445
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Entity Type | Organization
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Legal Business Name | KIST FAMILY CHIROPRACTIC & WELLNESS CENTRE INC.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 2711 HUBBARD RD
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City | MADISON
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State | OH
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Zip | 44057
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Country | US
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Telephone | 440-428-0711
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Fax | 440-428-0760
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Provider Business Mailing Address
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Address Line | 2711 HUBBARD RD
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City | MADISON
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State | OH
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Zip | 44057
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Country | US
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Telephone | 440-428-0711
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Fax | 440-428-0760
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES K KIST
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Credential | DC
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Telephone | 440-428-0711
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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 | 2827
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2823
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License Number State | OH
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