Provider Demographics
NPI:1902109960
Name:LINZEY, KEVIN BARKLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BARKLEY
Last Name:LINZEY
Suffix:
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 1:191 LYNCH CREEK WAY
Mailing Address - Street 2:STE 201
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-2389
Mailing Address - Country:US
Mailing Address - Phone:707-762-4449
Mailing Address - Fax:707-762-4754
Practice Address - Street 1:191 LYNCH CREEK WAY
Practice Address - Street 2:STE 201
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2389
Practice Address - Country:US
Practice Address - Phone:707-762-4449
Practice Address - Fax:707-762-4754
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor