Provider Demographics
NPI:1922193424
Name:MADLER, KAYLA JO (DC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:JO
Last Name:MADLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:JO
Other - Last Name:KIESER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:WY
Mailing Address - Zip Code:82053-0333
Mailing Address - Country:US
Mailing Address - Phone:307-547-3330
Mailing Address - Fax:307-534-3339
Practice Address - Street 1:315 S MAIN ST #101
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:WY
Practice Address - Zip Code:82053-0333
Practice Address - Country:US
Practice Address - Phone:307-547-3330
Practice Address - Fax:307-547-3339
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY718111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor