Provider Demographics
NPI:1194123760
Name:BEARDSLEY, KAYLA R (DC)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:R
Last Name:BEARDSLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 SWEDESFORD RD STE B
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1530
Mailing Address - Country:US
Mailing Address - Phone:607-744-6324
Mailing Address - Fax:
Practice Address - Street 1:631 SWEDESFORD RD STE B
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1530
Practice Address - Country:US
Practice Address - Phone:607-744-6324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-15
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11842111N00000X
VT006.0108534111N00000X
PADC011515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor