Provider Demographics
NPI:1790017267
Name:UKRAINYC, KYLE LORIN (DC)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:LORIN
Last Name:UKRAINYC
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 1:220 STONE CROP RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-1320
Mailing Address - Country:US
Mailing Address - Phone:315-745-9163
Mailing Address - Fax:302-658-8886
Practice Address - Street 1:1600 N WASHINGTON ST
Practice Address - Street 2:FL 2
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4722
Practice Address - Country:US
Practice Address - Phone:315-745-9163
Practice Address - Fax:302-658-8886
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000795111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor