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KATHALYNAS SPINE SPORT & REHABILITATION LLC NPI 1336468966


NPI Information

NPI: 1336468966
Provider Name: KATHALYNAS SPINE, SPORT & REHABILITATION LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization

CLIA Number: 14D2235620

Address:
206 E CHURCH ST STE A
BENTON, IL
ZIP 62812
Phone: (618) 435-9393
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KATHALYNAS SPINE, SPORT & REHABILITATION LLC is a chiropractor in Benton, IL. 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. KATHALYNAS SPINE, SPORT & REHABILITATION LLC NPI is 1336468966. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

206 E CHURCH ST STE A
BENTON, IL
ZIP 62812-239
Phone: (618) 435-9393
Fax: (618) 937-3500

The provider's authorized official is Ryan Joe Kathalynas .
The authorized official title is Owner and has the following contact phone number (618) 932-2137.

The CLIA number assigned to this NPI record is 14D2235620 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2010 and was last updated on 10/8/2020.


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.