Provider Demographics
NPI:1972757201
Name:DAVIS L KINNEY DC PC
Entity type:Organization
Organization Name:DAVIS L KINNEY DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-435-4747
Mailing Address - Street 1:PO BOX 71593
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-1593
Mailing Address - Country:US
Mailing Address - Phone:229-435-4747
Mailing Address - Fax:229-435-6767
Practice Address - Street 1:2311 LAKE PARK DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3183
Practice Address - Country:US
Practice Address - Phone:229-435-4747
Practice Address - Fax:229-436-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty