Provider Demographics
NPI:1588861306
Name:KIELUR, JOSEPH S (D C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:KIELUR
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1606
Mailing Address - Country:US
Mailing Address - Phone:317-554-0748
Mailing Address - Fax:317-554-0749
Practice Address - Street 1:611 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1606
Practice Address - Country:US
Practice Address - Phone:317-554-0748
Practice Address - Fax:317-554-0749
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001412A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor