Provider Demographics
NPI:1598236770
Name:SCOTT, KYLIE RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:RENEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KYLIE
Other - Middle Name:RENEE
Other - Last Name:KEISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4009 W 49TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5221
Mailing Address - Country:US
Mailing Address - Phone:605-271-0119
Mailing Address - Fax:
Practice Address - Street 1:4009 W 49TH ST STE 310
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-5221
Practice Address - Country:US
Practice Address - Phone:605-271-0119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor