Provider Demographics
NPI:1023553898
Name:RABE, KYLIE PAIGE (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:PAIGE
Last Name:RABE
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 1:3725 EASTOVER RIDGE DR APT 1216
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1581
Mailing Address - Country:US
Mailing Address - Phone:515-664-0192
Mailing Address - Fax:
Practice Address - Street 1:434 N TRADE ST
Practice Address - Street 2:STE 103
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1729
Practice Address - Country:US
Practice Address - Phone:704-845-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4760111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4760OtherNC STATE BOARD