Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 8105 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 8105 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 8105 | TX |
NPI | 1285856674 |
---|---|
Provider Name | Dr. Cole Lindsey Kricken |
First Address | San Antonio, TX 78216-4363 |
Second Address | Dallas, TX 75206-1902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |