Provider Demographics
NPI:1336890037
Name:DUARTE, KYLE WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:WILLIAM
Last Name:DUARTE
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 1:2521 SCHIEFFELIN RD STE 130
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4417
Mailing Address - Country:US
Mailing Address - Phone:919-267-9771
Mailing Address - Fax:
Practice Address - Street 1:2521 SCHIEFFELIN RD STE 130
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4417
Practice Address - Country:US
Practice Address - Phone:919-267-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5354111N00000X, 111NS0005X
WA61243039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor