Deden, Kyle Stanley

Deden, Kyle Stanley is an sole proprietor health care provider with primary practice located at 611 Brighton Ave , Portland ME 04102-2322. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Deden, Kyle Stanley can be contacted via phone (207) 773-4651.

Contact Information

Primary practice address
611 Brighton Ave Portland ME 04102-2322
Phone: (207) 773-4651
Fax: (207) 773-8940
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 06446 Iowa
Chiropractic Providers / Chiropractor 111N00000X CR2084 Maine

Profile Details

NPI number 1366542532
LBN Legal business name Deden, Kyle Stanley
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Feb 22nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366542532 NPPES
Iowa MEDICAID 0463422
Iowa Other 39100

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