Provider Demographics
NPI:1285363721
Name:RICE, KAITLYN NICOLE (DC)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:NICOLE
Last Name:RICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-7439
Mailing Address - Country:US
Mailing Address - Phone:850-572-4610
Mailing Address - Fax:
Practice Address - Street 1:4350 MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7439
Practice Address - Country:US
Practice Address - Phone:704-702-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2025-01-20
Deactivation Date:2022-09-19
Deactivation Code:
Reactivation Date:2022-10-14
Provider Licenses
StateLicense IDTaxonomies
NC5477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor