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Individual

KYLE K PARRILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
916 TALON DR STE 102, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883
Mailing address
916 TALON DR STE 102, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038013254
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1811940893
TYPE II NPI
IL
Enumeration date
08/10/2018
Last updated
08/10/2018
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