Provider Demographics
NPI:1962951087
Name:KYLE CORBIN, DC PA
Entity type:Organization
Organization Name:KYLE CORBIN, DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:GARRETT
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-336-4114
Mailing Address - Street 1:664 TAUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-3117
Mailing Address - Country:US
Mailing Address - Phone:508-336-4114
Mailing Address - Fax:508-557-0261
Practice Address - Street 1:664 TAUNTON AVE
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-3117
Practice Address - Country:US
Practice Address - Phone:508-336-4114
Practice Address - Fax:508-557-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty