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General NPI Number Information
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NPI Number | 1841979473
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Entity Type | Individual
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Provider Name | KYLE R KLINGINSMITH DC
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Gender | Male
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 940 BELMONT ST
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City | BROCKTON
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State | MA
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Zip | 02301-5568
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Country | US
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Telephone | 816-645-3086
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Fax |
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Provider Business Mailing Address
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Address Line | 9229 WARD PKWY STE 105
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City | KANSAS CITY
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State | MO
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Zip | 64114-3359
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Country | US
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Telephone | 816-333-3331
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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 | 2022046531
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License Number State | MO
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