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Individual

DR. KYLE DAVID BOLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
N4622 COUNTY ROAD M, WEST SALEM, WI 54669-9522
(608) 612-0777
(608) 807-5142
Mailing address
N4622 COUNTY ROAD M, WEST SALEM, WI 54669-9522
(608) 612-0777
(608) 807-5142

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
007563
IA
111N00000X
Chiropractor
038011984
IL
111N00000X
Chiropractor
Primary
4770012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427338334
INDIVIDUAL NPI
WI
Enumeration date
08/23/2011
Last updated
07/09/2024
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