Healthcare Provider Details

I. General information

NPI: 1497143655
Provider Name (Legal Business Name): MICHAEL KYLE HART D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2014
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLUMBIA RD
SHINNSTON WV
26431-1016
US

IV. Provider business mailing address

PO BOX 112
FAIRMONT WV
26555-0112
US

V. Phone/Fax

Practice location:
  • Phone: 304-592-1040
  • Fax: 304-592-5317
Mailing address:
  • Phone: 304-366-0700
  • Fax: 304-366-9529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number982
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104557215
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: