Provider Demographics
NPI:1063028504
Name:KYLE UKRAINYC DC LLC
Entity Type:Organization
Organization Name:KYLE UKRAINYC DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:UKRAINYC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-745-9163
Mailing Address - Street 1:220 STONE CROP RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-1320
Mailing Address - Country:US
Mailing Address - Phone:315-745-9163
Mailing Address - Fax:302-658-8886
Practice Address - Street 1:1600 N WASHINGTON ST FL 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4722
Practice Address - Country:US
Practice Address - Phone:315-745-9163
Practice Address - Fax:302-658-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty