Provider Demographics
NPI:1881179166
Name:KYLES CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:KYLES CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:HENDERSON
Authorized Official - Last Name:KYLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-641-9102
Mailing Address - Street 1:109 GREENVILLE ST SW
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3810
Mailing Address - Country:US
Mailing Address - Phone:803-641-9102
Mailing Address - Fax:803-649-4499
Practice Address - Street 1:109 GREENVILLE ST SW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3810
Practice Address - Country:US
Practice Address - Phone:803-641-9102
Practice Address - Fax:803-649-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty