Provider Demographics
NPI:1578678074
Name:VOLZ, KYLENE LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:KYLENE
Middle Name:LYNN
Last Name:VOLZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 CEDAR ST
Mailing Address - Street 2:SUITE #3
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-6630
Mailing Address - Country:US
Mailing Address - Phone:517-699-3000
Mailing Address - Fax:517-699-3610
Practice Address - Street 1:1995 CEDAR ST
Practice Address - Street 2:SUITE #3
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-6630
Practice Address - Country:US
Practice Address - Phone:517-699-3000
Practice Address - Fax:517-699-3610
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP21120Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #