Provider Demographics
NPI:1902305808
Name:BUTLER, KYLIE HISLOP (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:HISLOP
Last Name:BUTLER
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 1:306 MARSH ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28584-9337
Mailing Address - Country:US
Mailing Address - Phone:910-787-2621
Mailing Address - Fax:
Practice Address - Street 1:200 DOCTORS DR STE C
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6308
Practice Address - Country:US
Practice Address - Phone:910-787-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor