Provider Demographics
NPI:1851161848
Name:PROPST, KYLE JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:JASON
Last Name:PROPST
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 1:301 S TUBB ST STE F2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34760-8859
Mailing Address - Country:US
Mailing Address - Phone:407-789-3501
Mailing Address - Fax:407-789-3502
Practice Address - Street 1:301 S TUBB ST STE F2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:FL
Practice Address - Zip Code:34760-8859
Practice Address - Country:US
Practice Address - Phone:407-789-3501
Practice Address - Fax:407-789-3502
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor