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General NPI Number Information
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NPI Number | 1457014367
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Entity Type | Individual
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Provider Name | KYLE LEE CHESTER BS
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Gender | Male
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2434 RICHMILLER LN UNIT F
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City | BELPRE
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State | OH
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Zip | 45714-1075
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Country | US
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Telephone | 304-918-7980
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Fax |
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Provider Business Mailing Address
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Address Line | 174 WASHINGTON AVE
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City | CLARKSBURG
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State | WV
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Zip | 26301-2918
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Country | US
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Telephone | 859-533-7556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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