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KINGMAN CHIROPRACTIC CLINIC PC NPI 1003970930


NPI Information

NPI: 1003970930
Provider Name: KINGMAN CHIROPRACTIC CLINIC PC

Doing Business As: DENNIS D AND RYAN D GUSTAFSON DC

Classification: Chiropractor - 111N00000X
Entity Type: Organization

CLIA Number: 03D2078474

Address:
1910 LUCILLE AVE
KINGMAN, AZ
ZIP 86401
Phone: (928) 753-2047
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KINGMAN CHIROPRACTIC CLINIC PC is a chiropractor in Kingman, AZ. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. KINGMAN CHIROPRACTIC CLINIC PC NPI is 1003970930. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Dennis D And Ryan D Gustafson Dc.

The provider's business location address is:

1910 LUCILLE AVE
KINGMAN, AZ
ZIP 86401-693
Phone: (928) 753-2047
Fax: (928) 753-2020

The provider's authorized official is Ryan D Gustafson .
The authorized official title is President and has the following contact phone number (928) 753-2047.

The CLIA number assigned to this NPI record is 03D2078474 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2006 and was last updated on 7/11/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.