Individual
DR. KYLE AVIV FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2450 ATLANTA HWY, STE 1601, CUMMING, GA 30040
(678) 513-0095
(678) 513-0706
Mailing address
6564 BLUEWATER DRIVE, BUFORD, GA 30518
(770) 945-5953
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO7309
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52026308002
BCBS
GA
Enumeration date
01/23/2007
Last updated
07/08/2007
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