| Kody S Kettle, | |
|
24805 Pinebrook Rd Ste 314, Chantilly, VA 20152-4128 | |
| (702) 957-3373 | |
| Not Available |
| Full Name | Kody S Kettle |
|---|---|
| Gender | Male |
| Speciality | Chiropractic |
| Experience | 4 Years |
| Location | 24805 Pinebrook Rd Ste 314, Chantilly, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669129383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 01045557796 (Virginia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Integrated Healthcare Systems Inc | 2466735493 | 2 |
| Provider Name | Integrated Healthcare Systems Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1437693348 PECOS PAC ID: 2466735493 Enrollment ID: O20170216001585 |
| Mailing Address | Practice Location Address |
|---|---|
| Kody S Kettle, 24805 Pinebrook Rd Ste 314, Chantilly, VA 20152-4128 Ph: (703) 957-3373 | Kody S Kettle, 24805 Pinebrook Rd Ste 314, Chantilly, VA 20152-4128 Ph: (702) 957-3373 |
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