Provider Demographics
NPI:1386080885
Name:MOSER, KYLE R (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:R
Last Name:MOSER
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 1:130 S HALCYON RD STE B
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3148
Mailing Address - Country:US
Mailing Address - Phone:805-709-5343
Mailing Address - Fax:
Practice Address - Street 1:130 S HALCYON RD STE B
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3148
Practice Address - Country:US
Practice Address - Phone:805-481-8508
Practice Address - Fax:805-481-6839
Is Sole Proprietor?:No
Enumeration Date:2013-05-12
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1259111N00000X
CADC32314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor