Individual
KYLE JOHN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
918 N.W. 32ND STREET, SUITE NUMBER 918, NEWCASTLE, OK 73065-1077
(405) 387-4011
(405) 387-4041
Mailing address
PO BOX 1077, NEWCASTLE, OK 73065-1077
(405) 387-4011
(405) 387-4041
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3854
OK
Other
Enumeration date
12/06/2007
Last updated
12/06/2007
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