Healthcare Provider Details

I. General information

NPI: 1316602097
Provider Name (Legal Business Name): KEVIN PISLE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 N CABLE RD STE D
LIMA OH
45805-1707
US

IV. Provider business mailing address

2297 JUNE DR
LIMA OH
45805-3726
US

V. Phone/Fax

Practice location:
  • Phone: 419-230-0032
  • Fax:
Mailing address:
  • Phone: 419-234-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2021042319
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: