Provider Demographics
NPI:1043669542
Name:SMERGLIA, KYLE (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:SMERGLIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 PORTAGE TRL
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1740
Mailing Address - Country:US
Mailing Address - Phone:330-928-2000
Mailing Address - Fax:
Practice Address - Street 1:1821 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223
Practice Address - Country:US
Practice Address - Phone:330-928-2000
Practice Address - Fax:330-920-4287
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0264521Medicaid