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Individual

DR. KEVIN MATTHEW KERCHANSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, FNP-C, DACRB

Contact information

Practice address
6036 N 19TH AVE STE 204, PHOENIX, AZ 85015-2104
(480) 616-0356
(480) 616-0603
Mailing address
PO BOX 29650 DEPT # 880391, PHOENIX, AZ 85038
(480) 626-1746
(480) 626-2690

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3728
OH
363LF0000X
Family Nurse Practitioner
Primary
251086
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11172882
CAQH #
OH
Enumeration date
03/12/2007
Last updated
09/28/2022
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