Provider Demographics
NPI:1477972164
Name:MUIR, KYLE SETH (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:SETH
Last Name:MUIR
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 1:307 BARON CT
Mailing Address - Street 2:
Mailing Address - City:ZELIENOPLE
Mailing Address - State:PA
Mailing Address - Zip Code:16063-2406
Mailing Address - Country:US
Mailing Address - Phone:330-360-6264
Mailing Address - Fax:
Practice Address - Street 1:1280 BOARDMAN CANFIELD RD STE 1
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4073
Practice Address - Country:US
Practice Address - Phone:330-360-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010881111N00000X
PAAJ010659111NR0400X
OHDC-04826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation