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General NPI Number Information
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NPI Number | 1427029339
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Entity Type | Individual
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Provider Name | KENNETH J GOLDEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 6925 E 96TH ST SUITE 125
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-3644
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Country | US
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Telephone | 317-594-0004
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Fax | 317-594-0005
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Provider Business Mailing Address
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Address Line | 6925 E 96TH ST SUITE 125
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-3644
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Country | US
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Telephone | 317-594-0004
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Fax | 317-594-0005
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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 | 08002147A
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License Number State | IN
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