Basic Information
| Provider Information | |||||||||
| NPI: | 1992740138 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRIGGERS | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | SHANE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 ROCK DOVE LN | ||||||||
| Address2: | |||||||||
| City: | MCQUEENEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781233241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8305603073 | ||||||||
| FaxNumber: | 2104903911 | ||||||||
| Practice Location | |||||||||
| Address1: | 1042 CENTRAL PKWY S | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782325021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104903900 | ||||||||
| FaxNumber: | 2104903911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 03/14/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 6961 | TX | Y | Chiropractic Providers | Chiropractor |
No ID Information.