Provider Demographics
NPI:1366721748
Name:KENDALL CARE, LLC
Entity type:Organization
Organization Name:KENDALL CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:RACHELE
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-488-6888
Mailing Address - Street 1:190 S PEYTONVILLE AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6937
Mailing Address - Country:US
Mailing Address - Phone:817-488-6888
Mailing Address - Fax:817-488-5888
Practice Address - Street 1:190 S PEYTONVILLE AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6937
Practice Address - Country:US
Practice Address - Phone:817-488-6888
Practice Address - Fax:817-488-5888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty