Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 03394 | MD |
N | 111NR0400X | Rehabilitation Chiropractor | CH030046 | DC |
NPI | 1174685002 |
---|---|
Provider Name | Dr. Kindra J Ingram |
First Address | Silver Spring, MD 20910-2816 |
Second Address | Silver Spring, MD 20910-2816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 26/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V05651 | (02) | MD |