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Individual

DR. DARRELL R KILCUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
7016 N 27TH AVE, PHOENIX, AZ 85051-8402
(602) 864-0304
(602) 864-0990
Mailing address
7016 N 27TH AVE, PHOENIX, AZ 85051-8402
(602) 864-0304
(602) 864-0990

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4935
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0930450
BCBS PIN #
AZ
Enumeration date
07/15/2005
Last updated
06/16/2008
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