Provider Demographics
NPI:1154664233
Name:STEINEMAN, KYLE (DC, ATC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:STEINEMAN
Suffix:
Gender:M
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 E STATE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-7010
Mailing Address - Country:US
Mailing Address - Phone:260-245-0460
Mailing Address - Fax:260-245-0770
Practice Address - Street 1:6633 E STATE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-7010
Practice Address - Country:US
Practice Address - Phone:260-245-0460
Practice Address - Fax:260-245-0770
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL34982255A2300X
IN08002926A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer