Provider Demographics
NPI:1871864678
Name:KD CHIROPRACTIC
Entity type:Organization
Organization Name:KD CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKHAUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-475-8114
Mailing Address - Street 1:5751 PRESTON HWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-1349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5751 PRESTON HWY
Practice Address - Street 2:SUITE 108
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-1349
Practice Address - Country:US
Practice Address - Phone:502-961-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty