Individual
KIRBY KENNETH PERRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2199 JOLLY RD, SUITE # 140, OKEMOS, MI 48864-3968
(517) 381-1880
(517) 381-1990
Mailing address
2199 JOLLY RD, SUITE # 140, OKEMOS, MI 48864-3968
(517) 381-1880
(517) 381-1990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007563
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950C350 750
BCBS PIN
MI
Enumeration date
06/30/2005
Last updated
07/08/2009
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