Provider Demographics
NPI:1912236480
Name:HELD, KYLE BRADLEY (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:BRADLEY
Last Name:HELD
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 1:940 N 204TH AVE
Mailing Address - Street 2:STE. 240
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-4606
Mailing Address - Country:US
Mailing Address - Phone:402-502-1001
Mailing Address - Fax:402-502-6371
Practice Address - Street 1:940 N 204TH AVE
Practice Address - Street 2:STE. 240
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4606
Practice Address - Country:US
Practice Address - Phone:402-502-1001
Practice Address - Fax:402-502-6371
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-13
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor