Provider Demographics
NPI:1548691546
Name:KUN CHIROPRACTIC & WELLNESS, INC.
Entity type:Organization
Organization Name:KUN CHIROPRACTIC & WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-646-9355
Mailing Address - Street 1:214 E MATILIJA ST
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2722
Mailing Address - Country:US
Mailing Address - Phone:805-646-9355
Mailing Address - Fax:
Practice Address - Street 1:214 E MATILIJA ST
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2722
Practice Address - Country:US
Practice Address - Phone:805-646-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty