Provider Demographics
NPI:1487990610
Name:PELPHREY, KYLE ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ANDREW
Last Name:PELPHREY
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 1:616 WELLINGTON WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2734
Mailing Address - Country:US
Mailing Address - Phone:859-296-4889
Mailing Address - Fax:859-296-1628
Practice Address - Street 1:616 WELLINGTON WAY
Practice Address - Street 2:SUITE A
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2734
Practice Address - Country:US
Practice Address - Phone:859-296-4889
Practice Address - Fax:859-296-1628
Is Sole Proprietor?:No
Enumeration Date:2012-12-16
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor