Provider Demographics
NPI:1205016805
Name:ORMSBEE, KYLE STUART (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:STUART
Last Name:ORMSBEE
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 1:46056 CASS AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5243
Mailing Address - Country:US
Mailing Address - Phone:586-254-1020
Mailing Address - Fax:586-254-5272
Practice Address - Street 1:46056 CASS AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5243
Practice Address - Country:US
Practice Address - Phone:586-254-1020
Practice Address - Fax:586-254-5272
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950E016670OtherBCBSM
MI421657036OtherCOMMERCIAL
MI950E05247OtherBCN
MIU82409Medicare UPIN
MI0P11350001Medicare PIN
MI0N39660Medicare PIN
MI0P11350Medicare UPIN