Kaleo Chiropractic Clinic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11385 Issued in TX

Legal business name

KALEO CHIROPRACTIC CLINIC PLLC

Practice address

408 S Broadway Ave
Tyler, TX 75702-8101

Phone

(903) 595-5190

NPI assigned

Dec 9, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joe David Glenn, D.C.NPI 1477878841

Title

Chiropractor

Phone

(918) 728-9129

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joe Glenn, D.C.

  • Chiropractor
  • Tyler, TX
  • NPI 1477878841
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1053614271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028101",
            "telephone_number": "903-595-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028101",
            "telephone_number": "903-595-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEO CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "918-728-9129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prapairi Joy Judson
• Krystal Juelg
• Julie T Haygood MD PA
• Adam Justice, APRN, ACNPC-AG
• Cynthia Lynn Kalawe, PT
• Shaheera Kamal, MD
• Sufiyan Kamal, MD
• Kenneth Joseph Kaminski Jr., MD
• Lauri Renee Kaminski, LMT
• Hirofumi Kanazawa

• Chiropractor in Tyler, TX
• Providers in Tyler, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.