Individual
DR. KYLE BANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
1543 GLADSTONE DR SE, GRAND RAPIDS, MI 49506-3922
(616) 520-3430
Mailing address
1543 GLADSTONE DR SE, GRAND RAPIDS, MI 49506-3922
(616) 520-3430
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301010298
MI
Other
Enumeration date
02/22/2015
Last updated
02/22/2015
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