Provider Demographics
NPI:1215578679
Name:MAXFIELD, KYLER (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLER
Middle Name:
Last Name:MAXFIELD
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 1:2766 COMMERCE DR NW STE C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2589
Mailing Address - Country:US
Mailing Address - Phone:507-258-4100
Mailing Address - Fax:
Practice Address - Street 1:2766 COMMERCE DR NW STE C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2589
Practice Address - Country:US
Practice Address - Phone:507-258-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6401111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor