Provider Demographics
NPI:1114064466
Name:HAGEL, KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:HAGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9446 36TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1718
Mailing Address - Country:US
Mailing Address - Phone:763-551-1344
Mailing Address - Fax:763-551-1544
Practice Address - Street 1:9446 36TH AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1718
Practice Address - Country:US
Practice Address - Phone:763-551-1344
Practice Address - Fax:763-551-1544
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350003570Medicare ID - Type Unspecified
MN08272Medicare UPIN