Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 23865 | CA |
NPI | 1003959297 |
---|---|
Provider Name | Dr. Scott E Kinney |
First Address | Ukiah, CA 95482-4345 |
Second Address | Ukiah, CA 95482-4345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |