Provider Demographics
NPI:1821075896
Name:PEPPLE, KYLE B (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:B
Last Name:PEPPLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:5830 CLARION ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-0380
Mailing Address - Country:US
Mailing Address - Phone:678-947-4449
Mailing Address - Fax:678-455-3655
Practice Address - Street 1:5830 CLARION ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-0380
Practice Address - Country:US
Practice Address - Phone:678-947-4449
Practice Address - Fax:678-455-3655
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2014-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR006074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU97144Medicare UPIN