Provider Demographics
NPI:1457837635
Name:MCCORMICK, KAYLEIGH MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYLEIGH
Middle Name:MICHELLE
Last Name:MCCORMICK
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 1:1351 KING AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2220
Mailing Address - Country:US
Mailing Address - Phone:614-488-6820
Mailing Address - Fax:
Practice Address - Street 1:1351 KING AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2220
Practice Address - Country:US
Practice Address - Phone:614-488-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor