Healthcare Provider Details

I. General information

NPI: 1861563710
Provider Name (Legal Business Name): KYLE ROSS KUHLMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8079 MANCHESTER RD
BRENTWOOD MO
63144-2817
US

IV. Provider business mailing address

9800 MANCHESTER RD STE B
SAINT LOUIS MO
63119-1253
US

V. Phone/Fax

Practice location:
  • Phone: 314-369-8987
  • Fax: 314-644-0449
Mailing address:
  • Phone: 314-369-8987
  • Fax: 314-644-0449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2003011601
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: