Individual
MARIAH CHEYENNE LYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
17138 320TH AVE, KEOTA, IA 52248
(641) 295-5389
Mailing address
17138 320TH AVE, KEOTA, IA 52248-8530
(641) 295-5389
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
094694
IA
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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