Provider Demographics
NPI:1457470742
Name:DRANEY, KYLE C (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:C
Last Name:DRANEY
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 1:2312 CRILL AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-4800
Mailing Address - Country:US
Mailing Address - Phone:904-540-6063
Mailing Address - Fax:386-385-5977
Practice Address - Street 1:2312 CRILL AVE STE 1B
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-4800
Practice Address - Country:US
Practice Address - Phone:904-540-6063
Practice Address - Fax:386-385-5977
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54010AMedicare ID - Type Unspecified
FLU92968Medicare UPIN