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NPI Code Detail

MEDICARE: KINNISON CHIROPRACTIC INC

MEDICARE: KINNISON CHIROPRACTIC INC
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
1111N00000XChiropractor6024AZ

General Provider Information

NPI Number : 1619057767
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINNISON CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 2001 N 4TH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-4227
Country : US
Telephone Number : 928-526-5797
Fax Number : 928-222-1775
Provider Business Practice Location Address
First Line : 2001 N 4TH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-4227
Country : US
Telephone Number : 928-526-5797
Fax Number : 928-222-1775
Authorized Official
Title or Position : PRESIDENT-OWNER
Name : GEOFFREY P KINNISON
Credential : D.C.
Telephone Number : 928-526-5797
Provider Enumeration Date : 10/16/2006
Last Update Date : 08/22/2020

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Directions to “KINNISON CHIROPRACTIC INC ” Practice Location

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