Provider Demographics
NPI:1255871448
Name:MINOGUE, KEVY SMITH (DC)
Entity type:Individual
Prefix:DR
First Name:KEVY
Middle Name:SMITH
Last Name:MINOGUE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6230
Mailing Address - Country:US
Mailing Address - Phone:518-587-2064
Mailing Address - Fax:518-587-0850
Practice Address - Street 1:3303 ROUTE 9
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6230
Practice Address - Country:US
Practice Address - Phone:518-587-2064
Practice Address - Fax:518-587-0850
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0129341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor