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General NPI Number Information
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NPI Number | 1861647232
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Entity Type | Organization
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Legal Business Name | KINSEY WELLNESS CORPORATION
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 11/26/2008
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Provider Practice Location Address
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Address Line | 8201 BROADWAY ST STE 103
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City | PEARLAND
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State | TX
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Zip | 77581-8923
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Country | US
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Telephone | 713-664-8150
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Fax | 713-664-8147
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Provider Business Mailing Address
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Address Line | 8201 BROADWAY ST STE 103
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City | PEARLAND
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State | TX
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Zip | 77581-8923
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Country | US
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Telephone | 713-664-8150
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Fax | 713-664-8147
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. CLINTON NIELS KINSEY
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Credential | DC
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Telephone | 713-664-8150
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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 | 7019
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License Number State | TX
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