Provider Demographics
NPI:1407139025
Name:LANDERS, DAVID KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KYLE
Last Name:LANDERS
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 1:1146 N BRINDLEE MOUNTAIN PKWY
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-1063
Mailing Address - Country:US
Mailing Address - Phone:256-586-5322
Mailing Address - Fax:256-931-4277
Practice Address - Street 1:1146 N BRINDLEE MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1063
Practice Address - Country:US
Practice Address - Phone:256-586-5322
Practice Address - Fax:256-931-4277
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G703852Medicare PIN