Provider Demographics
NPI:1326808130
Name:HURT, KYLEIGH (DC)
Entity type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:
Last Name:HURT
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 FOX RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9483
Mailing Address - Country:US
Mailing Address - Phone:517-227-0217
Mailing Address - Fax:
Practice Address - Street 1:3476 STELLHORN RD # 51
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-4630
Practice Address - Country:US
Practice Address - Phone:517-278-2519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003436A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor