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NPI Code Detail

MEDICARE: KYLEIGH VINCENT D.C.

MEDICARE:   KYLEIGH  VINCENT  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor038012645IL

General Provider Information

NPI Number : 1205242922
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLEIGH VINCENT D.C.
Provider Business Mailing Address
First Line : 120 S DELMAR AVE
Second Line : SUITE B P.O. BOX 458
City : SALEM
State : IL
Zip : 62881-2000
Country : US
Telephone Number : 618-740-1711
Fax Number : 618-740-1722
Provider Business Practice Location Address
First Line : 120 S DELMAR AVE
Second Line : SUITE B
City : SALEM
State : IL
Zip : 62881-2000
Country : US
Telephone Number : 618-740-1711
Fax Number : 618-740-1722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2014
Last Update Date : 12/18/2015

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Directions to “ KYLEIGH VINCENT D.C.” Practice Location

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