Provider Demographics
NPI:1306819495
Name:TURNER, KYLE Q (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:Q
Last Name:TURNER
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15754 N BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8839
Mailing Address - Country:US
Mailing Address - Phone:623-266-8124
Mailing Address - Fax:623-322-3148
Practice Address - Street 1:15754 N BULLARD AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8839
Practice Address - Country:US
Practice Address - Phone:623-266-8124
Practice Address - Fax:623-322-3148
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZA0409174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist