Urban, Kenneth A.

Urban, Kenneth A. is an sole proprietor health care provider with primary practice located at 1624 E Mason St , Green Bay WI 54302-2739. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Sports Physician, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is his primary health care specialty. Urban, Kenneth A. can be contacted via phone (920) 465-0400.

Contact Information

Primary practice address
1624 E Mason St Green Bay WI 54302-2739
Phone: (920) 465-0400
Fax: (920) 465-1430
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 1483 Wisconsin
Chiropractic Providers / Chiropractor 111N00000X 1483 Wisconsin

Profile Details

NPI number 1346336096
LBN Legal business name Urban, Kenneth A.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2006
Last updated Nov 28th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346336096 NPPES
Wisconsin MEDICAID 38757000

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