Organization
DANIEL J KINKEAD PC
Active
Other names
KINKEAD CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J. KINKEAD P.C. (OWNER)
(480) 838-6696
Entity
Organization
Contact information
Practice address
3614 E SOUTHERN AVE, SUITE A-105, MESA, AZ 85206-2509
(480) 838-6696
(480) 838-9392
Mailing address
3614 E SOUTHERN AVE, SUITE A-105, MESA, AZ 85206-2509
(480) 838-6696
(480) 838-9392
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
AZ4294
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004266286
AETNA PIN
AZ
01
—
215276
CIGNA PROVIDER NUMBER
AZ
01
—
AZ0932910
BCBS ID
AZ
Enumeration date
09/05/2008
Last updated
05/28/2019
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