Provider Demographics
NPI:1104410117
Name:KSS HEALTHCARE PLLC
Entity type:Organization
Organization Name:KSS HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-896-7571
Mailing Address - Street 1:21121 CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8207
Mailing Address - Country:US
Mailing Address - Phone:704-896-7571
Mailing Address - Fax:704-896-7471
Practice Address - Street 1:21121 CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8207
Practice Address - Country:US
Practice Address - Phone:704-896-7571
Practice Address - Fax:704-896-7471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1255679015OtherNON PARTICIPATING