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General NPI Number Information
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NPI Number | 1447355482
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Entity Type | Individual
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Provider Name | MARVIN I KUNIKIYO D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 5401 CORPORATE CENTER LOOP SE STE R
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City | LACEY
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State | WA
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Zip | 98503-5606
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Country | US
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Telephone | 360-918-8782
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Fax | 360-972-2096
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Provider Business Mailing Address
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Address Line | 5401 CORPORATE CENTER LOOP SE STE R
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City | LACEY
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State | WA
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Zip | 98503-5606
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Country | US
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Telephone | 360-918-8782
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Fax | 360-972-2096
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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 | CH00002656
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License Number State | WA
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