Provider Demographics
NPI:1376212563
Name:ROMEO, KAYLA (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:ROMEO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8203 CIPOLLINI ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4285
Mailing Address - Country:US
Mailing Address - Phone:703-300-6009
Mailing Address - Fax:
Practice Address - Street 1:3519 PELHAM RD STE 107
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4182
Practice Address - Country:US
Practice Address - Phone:864-559-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor