Provider Demographics
NPI:1437545951
Name:STEVENSON, KYLEE (DC)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KYLEE
Other - Middle Name:
Other - Last Name:MCGARVIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:19555 W BLUEMOUND RD STE 6
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5934
Mailing Address - Country:US
Mailing Address - Phone:360-461-5777
Mailing Address - Fax:
Practice Address - Street 1:19555 W BLUEMOUND RD STE 6
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045
Practice Address - Country:US
Practice Address - Phone:262-649-7876
Practice Address - Fax:262-456-5930
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5379-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor