Provider Demographics
NPI:1831487453
Name:BROYLES, JOSEPH KYLE
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KYLE
Last Name:BROYLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 BURBANK BLVD # F4
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-5765
Mailing Address - Country:US
Mailing Address - Phone:818-922-9938
Mailing Address - Fax:818-344-4724
Practice Address - Street 1:11311 BURBANK BLVD # F4
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-5765
Practice Address - Country:US
Practice Address - Phone:818-922-9938
Practice Address - Fax:818-344-4724
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2011-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies