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General NPI Number Information
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NPI Number | 1790729010
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Entity Type | Organization
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Legal Business Name | KIMEL CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 13615 N 35TH AVE #1
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City | PHOENIX
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State | AZ
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Zip | 85029
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Country | US
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Telephone | 602-993-1722
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Fax | 602-866-0219
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Provider Business Mailing Address
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Address Line | 13615 N 35TH AVE #1
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City | PHOENIX
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State | AZ
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Zip | 85029
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Country | US
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Telephone | 602-993-1722
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Fax | 602-866-0219
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Authorized Official
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Title or Position | VICE PRES
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Name | DR. GENE BRADLEY KIMEL
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Credential | DC
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Telephone | 602-993-1722
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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 | 4269
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7481
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7857
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5350
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License Number State | AZ
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