Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1731 | NC |
NPI | 1689741274 |
---|---|
Provider Name | Dr. Kenneth M Lommel |
First Address | Siler City, NC 27344-3122 |
Second Address | Siler City, NC 27344-3122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
890858 | (05) | NC |
T40902 | (02) | NC |