Provider Demographics
NPI:1073738662
Name:LYLE, NATALIE M (DC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:LYLE
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 1:3083 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:303-440-0500
Mailing Address - Fax:303-440-4621
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:303-440-0500
Practice Address - Fax:303-440-4621
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH273-0996111N00000X
SC4250111N00000X
COCHR.0007347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4304073OtherCIGNA