Provider Demographics
NPI:1710300652
Name:HARTLEY, KAYCIE LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYCIE
Middle Name:LOUISE
Last Name:HARTLEY
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 1:2202 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2623
Mailing Address - Country:US
Mailing Address - Phone:352-816-4161
Mailing Address - Fax:
Practice Address - Street 1:2202 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2623
Practice Address - Country:US
Practice Address - Phone:352-861-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor