Provider Demographics
NPI:1003527052
Name:SMITH, KAYLA JANELLE (DC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:JANELLE
Last Name:SMITH
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 1:28870 VERSOL DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6551
Mailing Address - Country:US
Mailing Address - Phone:412-292-0605
Mailing Address - Fax:
Practice Address - Street 1:28870 VERSOL DR UNIT 104
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-6551
Practice Address - Country:US
Practice Address - Phone:412-292-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor