Healthcare Provider Details

I. General information

NPI: 1144681958
Provider Name (Legal Business Name): KYLE L HANFORD DC, CCSP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6711 DEBARR RD
ANCHORAGE AK
99504-1803
US

IV. Provider business mailing address

6711 DEBARR RD
ANCHORAGE AK
99504-1803
US

V. Phone/Fax

Practice location:
  • Phone: 907-333-6525
  • Fax:
Mailing address:
  • Phone: 907-333-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number103010
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01721
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number103010
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: