Provider Demographics
NPI:1447340062
Name:KUCHLER, THEODORE CHARLES III (DC)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:CHARLES
Last Name:KUCHLER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 ATLANTIC BLVD.
Mailing Address - Street 2:SUITE 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3125
Mailing Address - Country:US
Mailing Address - Phone:904-220-6461
Mailing Address - Fax:904-220-8953
Practice Address - Street 1:13121 ATLANTIC BLVD.
Practice Address - Street 2:SUITE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-3125
Practice Address - Country:US
Practice Address - Phone:904-220-6461
Practice Address - Fax:904-220-8953
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU92967Medicare UPIN
FL22166Medicare ID - Type Unspecified