Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR010697 | GA |
NPI | 1003568700 |
---|---|
Provider Name | Dr. Kyle Soles |
First Address | Roswell, GA 30075-3650 |
Second Address | Alpharetta, GA 30005-1635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2022 |
Last Update Date | 24/01/2022 |