Provider Demographics
NPI:1730953647
Name:KRAKEN CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:KRAKEN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRUNEWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-379-7079
Mailing Address - Street 1:333 E BETHANY DR STE A100
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3815
Mailing Address - Country:US
Mailing Address - Phone:972-370-7079
Mailing Address - Fax:972-924-6840
Practice Address - Street 1:333 E BETHANY DR STE A100
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3815
Practice Address - Country:US
Practice Address - Phone:972-370-7079
Practice Address - Fax:972-924-6840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty