Provider Demographics
NPI:1043772544
Name:LYLE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:LYLE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-440-0500
Mailing Address - Street 1:3083 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2509
Mailing Address - Country:US
Mailing Address - Phone:303-440-0550
Mailing Address - Fax:
Practice Address - Street 1:3083 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2509
Practice Address - Country:US
Practice Address - Phone:303-440-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty