Provider Demographics
NPI:1841522869
Name:FRENCH, KYLE EARL (DC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:EARL
Last Name:FRENCH
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:PO BOX 2084
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-2084
Mailing Address - Country:US
Mailing Address - Phone:928-567-0202
Mailing Address - Fax:928-567-0303
Practice Address - Street 1:564 S MAIN STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322
Practice Address - Country:US
Practice Address - Phone:928-567-0202
Practice Address - Fax:928-567-0303
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ136698OtherMEDICARE PTAN