Provider Demographics
NPI:1619553609
Name:HUKILL, KODY WAYNE (DC)
Entity type:Individual
Prefix:
First Name:KODY
Middle Name:WAYNE
Last Name:HUKILL
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 1:601 E CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-8130
Mailing Address - Country:US
Mailing Address - Phone:517-278-7246
Mailing Address - Fax:517-279-2858
Practice Address - Street 1:601 E CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-8130
Practice Address - Country:US
Practice Address - Phone:517-278-7246
Practice Address - Fax:517-279-2858
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011060111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor