Provider Demographics
NPI:1285744284
Name:KENDZIA, KRISTINA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:MARIE
Last Name:KENDZIA
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 1:6035 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6865
Mailing Address - Country:US
Mailing Address - Phone:716-632-4476
Mailing Address - Fax:716-632-4503
Practice Address - Street 1:6035 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6865
Practice Address - Country:US
Practice Address - Phone:716-632-4476
Practice Address - Fax:716-632-4503
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010759-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX010759-1OtherLICENSE