Provider Demographics
NPI:1578108239
Name:RAHN, KYLE (DC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:RAHN
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 1:793 S MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3094
Mailing Address - Country:US
Mailing Address - Phone:810-664-3333
Mailing Address - Fax:810-664-1361
Practice Address - Street 1:793 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3094
Practice Address - Country:US
Practice Address - Phone:810-664-3333
Practice Address - Fax:810-664-1361
Is Sole Proprietor?:No
Enumeration Date:2019-11-16
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor