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Individual
JEFFERY SHANE KINNARD
Active
Individual
JEFFERY SHANE KINNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0006693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225845
CHIRO ALLIANCE CORP.
FL
01
—
350043240
MEDICARE R.R.
FL
05
—
380499200
—
FL
01
—
5503335
GHI
FL
01
—
55185
BLUE CROSS/BLUE SHIELD
FL
01
—
593483676
TAX-ID
FL
01
—
U51777
UPIN
FL
Enumeration date
07/24/2006
Last updated
09/06/2011
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