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General NPI Number Information
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NPI Number | 1831393586
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Entity Type | Organization
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Legal Business Name | BUCKLE FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 38807 ANN ARBOR RD STE 5
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City | LIVONIA
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State | MI
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Zip | 48150-3896
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Country | US
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Telephone | 734-953-9933
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Fax | 734-953-9966
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Provider Business Mailing Address
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Address Line | 38807 ANN ARBOR RD STE 5
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City | LIVONIA
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State | MI
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Zip | 48150-3896
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Country | US
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Telephone | 734-953-9933
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Fax | 734-953-9966
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KYLE WILFRED PATRICK BUCKLE
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Credential | D.C.
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Telephone | 248-349-9933
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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 | 2301009171
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License Number State | MI
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