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General NPI Number Information
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NPI Number | 1548282965
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Entity Type | Individual
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Provider Name | JEFFERY SHANE KINNARD D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | 2611 HIGHWAY 44 W
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City | INVERNESS
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State | FL
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Zip | 34453-3725
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Country | US
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Telephone | 352-726-0554
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Fax | 352-728-3885
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Provider Business Mailing Address
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Address Line | 2611 HIGHWAY 44 W
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City | INVERNESS
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State | FL
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Zip | 34453-3725
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Country | US
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Telephone | 352-726-0554
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Fax | 352-728-3885
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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 | CH0006693
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License Number State | FL
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