Provider Demographics
NPI:1538119342
Name:DOYLE, KRISTEN PATRICE (DC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:PATRICE
Last Name:DOYLE
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 1:7 VANDERVEER AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2343
Mailing Address - Country:US
Mailing Address - Phone:215-364-1939
Mailing Address - Fax:215-343-6247
Practice Address - Street 1:7 VANDERVEER AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-2343
Practice Address - Country:US
Practice Address - Phone:215-364-1939
Practice Address - Fax:215-343-6247
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007020-L111N00000X
PADC007020L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MC021092Medicare PIN
PAU72663Medicare UPIN