Provider Demographics
NPI:1194708685
Name:KARBASSY, KYAN (DC)
Entity type:Individual
Prefix:
First Name:KYAN
Middle Name:
Last Name:KARBASSY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8390 E VIA DE VENTURA
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3188
Mailing Address - Country:US
Mailing Address - Phone:480-922-4882
Mailing Address - Fax:480-998-5503
Practice Address - Street 1:8390 E VIA DE VENTURA
Practice Address - Street 2:F-114
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3188
Practice Address - Country:US
Practice Address - Phone:480-922-4882
Practice Address - Fax:480-998-5503
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor