MEDICARE: KINNEY CHIROPRACTIC HEALTHCARE, LLC

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

General Provider Information

NPI Number	:	1205154382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINNEY CHIROPRACTIC HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	5805 SAINTSBURY WEST
Second Line	:	SUITE 107
City	:	THE COLONY
State	:	TX
Zip	:	75056
Country	:	US
Telephone Number	:	972-820-5880
Fax Number	:	972-820-5878

Provider Business Practice Location Address
First Line	:	5805 SAINTSBURY DR
Second Line	:	SUITE 107
City	:	THE COLONY
State	:	TX
Zip	:	75056-5459
Country	:	US
Telephone Number	:	972-820-5880
Fax Number	:	972-820-5878

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TROY KINNEY
Credential	:	D.C.
Telephone Number	:	972-768-7518

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

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