Healthcare Provider Details

I. General information

NPI: 1326808130
Provider Name (Legal Business Name): KYLEIGH HURT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3476 STELLHORN RD # 51
FORT WAYNE IN
46815-4630
US

IV. Provider business mailing address

408 FOX RD
COLDWATER MI
49036-9483
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-2519
  • Fax:
Mailing address:
  • Phone: 517-227-0217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08003436A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: