Provider Demographics
NPI:1902981681
Name:HARKLEROAD, KRIS ARTHUR (DC)
Entity Type:Individual
Prefix:MR
First Name:KRIS
Middle Name:ARTHUR
Last Name:HARKLEROAD
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 1:1768 NAPA ST
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-4019
Mailing Address - Country:US
Mailing Address - Phone:831-644-9124
Mailing Address - Fax:831-643-9010
Practice Address - Street 1:1011 CASS ST STE 202
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4533
Practice Address - Country:US
Practice Address - Phone:831-644-9124
Practice Address - Fax:831-643-9010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU98087Medicare UPIN
DC0181930Medicare ID - Type Unspecified