Provider Demographics
NPI:1356469308
Name:J. KYLE EATON, D.C., P.C.
Entity Type:Organization
Organization Name:J. KYLE EATON, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-221-2442
Mailing Address - Street 1:2753 HIGHWAY 195
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35503-6241
Mailing Address - Country:US
Mailing Address - Phone:205-221-2442
Mailing Address - Fax:205-221-2437
Practice Address - Street 1:2753 HIGHWAY 195
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35503-6241
Practice Address - Country:US
Practice Address - Phone:205-221-2442
Practice Address - Fax:205-221-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty