MEDICARE: DR. KATHLEEN BARNETT-WOLK 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	111NI0013X	Independent Medical Examiner Chiropractor	B00960	NV

General Provider Information

NPI Number	:	1629237524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN BARNETT-WOLK D.C.

Provider Business Mailing Address
First Line	:	4516 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1502
Country	:	US
Telephone Number	:	702-259-8001
Fax Number	:	702-259-8005

Provider Business Practice Location Address
First Line	:	4516 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1502
Country	:	US
Telephone Number	:	702-259-8001
Fax Number	:	702-259-8005

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	06/05/2008

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