Provider Demographics
NPI:1730666223
Name:GVILLO, KYLE RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:RAY
Last Name:GVILLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:907 AVALON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2307
Mailing Address - Country:US
Mailing Address - Phone:256-314-2213
Mailing Address - Fax:256-251-6220
Practice Address - Street 1:907 AVALON AVE STE B
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2307
Practice Address - Country:US
Practice Address - Phone:256-314-2213
Practice Address - Fax:256-251-6220
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor