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NPI Code Detail

MEDICARE: DR. KYLE WAYNE NEVILL D.C.

MEDICARE:  DR. KYLE WAYNE NEVILL  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
1111N00000XChiropractor038012342IL

General Provider Information

NPI Number : 1952648362
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE WAYNE NEVILL D.C.
Provider Business Mailing Address
First Line : 2700 W LAWRENCE AVE
Second Line : SUITE J-4
City : SPRINGFIELD
State : IL
Zip : 62704-1181
Country : US
Telephone Number : 217-546-6698
Fax Number : 217-546-4487
Provider Business Practice Location Address
First Line : 2700 W LAWRENCE AVE
Second Line : SUITE J-4
City : SPRINGFIELD
State : IL
Zip : 62704-1181
Country : US
Telephone Number : 217-546-6698
Fax Number : 217-546-4487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2013
Last Update Date : 01/07/2013

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Directions to “ DR. KYLE WAYNE NEVILL D.C.” Practice Location

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