Provider Demographics
NPI:1447349253
Name:LAMARRE, KYM (DC)
Entity type:Individual
Prefix:DR
First Name:KYM
Middle Name:
Last Name:LAMARRE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KYM
Other - Middle Name:
Other - Last Name:ERNEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:323 N THOR ST
Mailing Address - Street 2:STE C
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4032
Mailing Address - Country:US
Mailing Address - Phone:209-632-3297
Mailing Address - Fax:
Practice Address - Street 1:323 N THOR ST
Practice Address - Street 2:STE C
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4032
Practice Address - Country:US
Practice Address - Phone:209-632-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21675111N00000X
MADC 1596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor