MEDICARE: KIMBLE CHIROPRACTIC CLINIC, 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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1629199948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMBLE CHIROPRACTIC CLINIC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 219
Second Line	:
City	:	KARNES CITY
State	:	TX
Zip	:	78114
Country	:	US
Telephone Number	:	830-780-2213
Fax Number	:	830-780-2558

Provider Business Practice Location Address
First Line	:	413 E CALVERT AVE
Second Line	:
City	:	KARNES CITY
State	:	TX
Zip	:	78118-3213
Country	:	US
Telephone Number	:	830-780-2213
Fax Number	:

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	SCOTT D KIMBLE
Credential	:	DC
Telephone Number	:	830-780-2213

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/01/2011

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