Individual
KYLE BRUKETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7310 N VILLA LAKE DR, PEORIA, IL 61614-8267
(309) 691-9767
Mailing address
7310 N VILLA LAKE DR, PEORIA, IL 61614-8267
(309) 691-9767
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.012927
IL
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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