Provider Demographics
NPI:1942321161
Name:KAUL FAMILY CHIROPRACTIC AND MASSAGE DC PC
Entity type:Organization
Organization Name:KAUL FAMILY CHIROPRACTIC AND MASSAGE DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-672-8831
Mailing Address - Street 1:1844 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2717
Mailing Address - Country:US
Mailing Address - Phone:541-672-8831
Mailing Address - Fax:541-672-0019
Practice Address - Street 1:1844 W HARVARD AVE
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-2717
Practice Address - Country:US
Practice Address - Phone:541-672-8831
Practice Address - Fax:541-672-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR133638Medicare PIN