Individual
DR. DANIEL J. KINKEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3614 E SOUTHERN AVE, SUITE A-105, MESA, AZ 85206-2509
(602) 833-3199
(602) 833-3190
Mailing address
3614 E SOUTHERN AVE # A105, MESA, AZ 85206-2509
(480) 838-6696
(480) 838-9392
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
AZ4294
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0932910
BCBS ID#
AZ
Enumeration date
10/20/2006
Last updated
12/05/2018
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