# ABUNDANT LIFE CHIROPRACTIC A CREATING WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457539074
- **Authorized official:** DR. KAYCIE A KIMBERLIN DC (PARTNER)
- **Authorized official phone:** (845) 331-8810

## Contact information

- **Practice address:** 327 BROADWAY, PORT EWEN, NY 12466-0927
- **Practice address phone:** (845) 331-8810
- **Mailing address:** 327 BROADWAY, PORT EWEN, NY 12466-0927
- **Mailing address phone:** (845) 331-8810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X009059 | NY | Yes |

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 02/06/2008