Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 103010 | AK |
Y | 111N00000X | Chiropractor | B01721 | NV |
N | 111NS0005X | Chiropractic Sports Physician | 103010 | AK |
NPI | 1144681958 |
---|---|
Provider Name | Dr. Kyle Lawrence Hanford |
First Address | Fernley, NV 89408-7718 |
Second Address | Fernley, NV 89408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2016 |
Last Update Date | 11/06/2019 |