MEDICARE: NETA M KIMEL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5350	AZ

General Provider Information

NPI Number	:	1134153232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NETA M KIMEL DC

Provider Business Mailing Address
First Line	:	13615 N 35TH AVE
Second Line	:	#1
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1243
Country	:	US
Telephone Number	:	602-993-1722
Fax Number	:

Provider Business Practice Location Address
First Line	:	13615 N 35TH AVE
Second Line	:	SUITE 1
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1243
Country	:	US
Telephone Number	:	602-993-1722
Fax Number	:	602-866-0219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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Directions to “ NETA M KIMEL DC” Practice Location

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