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General NPI Number Information
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NPI Number | 1588209977
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Entity Type | Organization
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Legal Business Name | KAISK CHIROPRACTIC
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Dates
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Enumeration Date | 11/09/2019
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Last Update Date | 11/09/2019
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Provider Practice Location Address
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Address Line | 120 UNIONVILLE INDIAN TRAIL RD W STE C102
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-5670
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Country | US
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Telephone | 704-821-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 120 UNIONVILLE INDIAN TRAIL RD W STE C102
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-5670
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Country | US
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Telephone | 704-821-5000
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Fax |
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Authorized Official
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Title or Position | OWNER / CHIROPRACTOR
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Name | DR. MICHAEL KAISK
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Credential | DC
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Telephone | 330-819-5116
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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 |
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License Number State |
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