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General NPI Number Information
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NPI Number | 1437346855
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Entity Type | Organization
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Legal Business Name | DAVID W. KINNISON
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 1740 RUFE SNOW DR STE B
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City | KELLER
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State | TX
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Zip | 76248-5669
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Country | US
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Telephone | 817-605-8363
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Fax | 817-605-8364
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Provider Business Mailing Address
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Address Line | 1740 RUFE SNOW DR STE B
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City | KELLER
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State | TX
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Zip | 76248-5669
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Country | US
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Telephone | 817-605-8363
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Fax | 817-605-8364
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Authorized Official
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Title or Position | CHIROPRACTOR/PROPRIETOR
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Name | DAV ID W. KINNISON
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Credential | D.C.
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Telephone | 817-605-8583
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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 | 9020
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License Number State | TX
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