Healthcare Provider Details

I. General information

NPI: 1811975576
Provider Name (Legal Business Name): KYLE HENRY HOEFT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 N KEYSTONE AVE
INDIANAPOLIS IN
46220-2156
US

IV. Provider business mailing address

6301 N KEYSTONE AVE
INDIANAPOLIS IN
46220-2156
US

V. Phone/Fax

Practice location:
  • Phone: 317-257-2225
  • Fax: 317-257-0646
Mailing address:
  • Phone: 317-257-2225
  • Fax: 317-257-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001970A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: