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General NPI Number Information
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NPI Number | 1568515583
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Entity Type | Organization
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Legal Business Name | KUKURIN CHIROPRACTIC
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Dates
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Enumeration Date | 01/21/2007
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 12409 W INDIAN SCHOOL RD C304
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City | AVONDALE
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State | AZ
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Zip | 85323-9502
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Country | US
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Telephone | 623-547-4727
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Fax |
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Provider Business Mailing Address
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Address Line | 14327 W MONTE VISTA RD
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City | GOODYEAR
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State | AZ
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Zip | 85338-2327
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Country | US
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Telephone | 623-547-4727
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. GEORGE WILLIAM KUKURIN
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Credential | DC
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Telephone | 623-547-4727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 7366
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License Number State | AZ
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