Individual
DR. KYLE JOHN PANKONIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
214 MAIN ST, LAMBERTON, MN 56152-1377
(507) 752-7650
(507) 752-7635
Mailing address
214 MAIN ST, PO BOX 517, LAMBERTON, MN 56152-1377
(507) 752-7650
(507) 752-7635
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC3858
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15F52RE
BLUE CROSS BLUE SHIELD
MN
01
—
411508205
HEALTH SERVICES MANAGEMEN
MN
Enumeration date
06/24/2005
Last updated
07/12/2010
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