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NPI Code Detail

MEDICARE: KYLE WITMER DEIMLER DC

MEDICARE:   KYLE WITMER DEIMLER  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2111N00000XChiropractorDC011468PA

General Provider Information

NPI Number : 1427521558
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE WITMER DEIMLER DC
Provider Business Mailing Address
First Line : 223 MULBERRY ST
Second Line :
City : NEWPORT
State : PA
Zip : 17074-1421
Country : US
Telephone Number : 717-982-7196
Fax Number :
Provider Business Practice Location Address
First Line : 223 MULBERRY ST
Second Line :
City : NEWPORT
State : PA
Zip : 17074-1421
Country : US
Telephone Number : 717-567-3158
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2019
Last Update Date : 04/10/2019

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Directions to “ KYLE WITMER DEIMLER DC” Practice Location

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