Provider Demographics
NPI:1558389148
Name:MCKAMEY, KYLE MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:MICHAEL
Last Name:MCKAMEY
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 1:114 COMMERCIAL ST
Mailing Address - Street 2:FL 2
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-1727
Mailing Address - Country:US
Mailing Address - Phone:269-462-9464
Mailing Address - Fax:269-462-9692
Practice Address - Street 1:114 COMMERCIAL ST
Practice Address - Street 2:FL 2
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1727
Practice Address - Country:US
Practice Address - Phone:269-462-9464
Practice Address - Fax:269-462-9692
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI008816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950H010250OtherMESSA
MI950H010250OtherBLUE CROSS BLUE SHIELD
MI7893544OtherAETNA
MI4800503Medicaid
MI950H010250OtherBLUE CROSS BLUE SHIELD