MEDICARE: DR. WIN EDWARD KRESSEL D.C.

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	5452	AZ

General Provider Information

NPI Number	:	1336271840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WIN EDWARD KRESSEL D.C.

Provider Business Mailing Address
First Line	:	3259 CATLIN AVE
Second Line	:
City	:	QUANTICO
State	:	VA
Zip	:	22134-5109
Country	:	US
Telephone Number	:	703-784-5541
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 E HIGHLAND AVE
Second Line	:	SUITE 110
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4835
Country	:	US
Telephone Number	:	602-955-5170
Fax Number	:	602-955-5173

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

Provider Enumeration Date	:	03/10/2007
Last Update Date	:	04/04/2024

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