Provider Demographics
NPI:1639632482
Name:KYLE LEDUC CHIROPRACTIC PLLC.
Entity Type:Organization
Organization Name:KYLE LEDUC CHIROPRACTIC PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEDUC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-686-3539
Mailing Address - Street 1:5101 THIMSEN AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4153
Mailing Address - Country:US
Mailing Address - Phone:952-232-4700
Mailing Address - Fax:952-232-4699
Practice Address - Street 1:5101 THIMSEN AVE STE 106
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4153
Practice Address - Country:US
Practice Address - Phone:952-232-4700
Practice Address - Fax:952-232-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty