Provider Demographics
NPI:1790031722
Name:NYE, KYLE TRAVIS (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:TRAVIS
Last Name:NYE
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 1:7836 MINERAL POINT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2088
Mailing Address - Country:US
Mailing Address - Phone:608-833-9445
Mailing Address - Fax:608-833-9447
Practice Address - Street 1:6502 NORMANDY LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1082
Practice Address - Country:US
Practice Address - Phone:608-833-9445
Practice Address - Fax:608-833-9447
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5499111N00000X
WI4905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor