Provider Demographics
NPI:1538254867
Name:KUENY CHIROPRACTIC PC
Entity type:Organization
Organization Name:KUENY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUENY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-200-3846
Mailing Address - Street 1:10 LAKE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALTA
Mailing Address - State:IA
Mailing Address - Zip Code:51002-1244
Mailing Address - Country:US
Mailing Address - Phone:712-200-3846
Mailing Address - Fax:
Practice Address - Street 1:10 LAKE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALTA
Practice Address - State:IA
Practice Address - Zip Code:51002-1244
Practice Address - Country:US
Practice Address - Phone:712-200-3846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI18755Medicare PIN