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General NPI Number Information
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NPI Number | 1801221361
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Entity Type | Individual
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Provider Name | KYLE ALEXANDER HANES D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 814 JUNIPER ST NE SUITE 201
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City | ATLANTA
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State | GA
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Zip | 30308-1300
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Country | US
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Telephone | 678-439-8581
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Fax |
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Provider Business Mailing Address
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Address Line | 116 PONCE DE LEON AVE NE #2319
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City | ATLANTA
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State | GA
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Zip | 30308-4113
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Country | US
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Telephone | 706-536-4165
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR009184
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License Number State | GA
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