Provider Demographics
NPI:1780471839
Name:TAPHOUSE-SPONSLER, KYLIE JO (MHA, DO)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:JO
Last Name:TAPHOUSE-SPONSLER
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Gender:
Credentials:MHA, DO
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Mailing Address - Street 1:4660 S HAGADORN RD STE 500
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6804
Mailing Address - Country:US
Mailing Address - Phone:517-432-6144
Mailing Address - Fax:
Practice Address - Street 1:4660 S HAGADORN RD STE 500
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6804
Practice Address - Country:US
Practice Address - Phone:517-432-6144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5151017566APP25204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM