Provider Demographics
NPI:1144930462
Name:AHRENS, KYLE J (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:J
Last Name:AHRENS
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 1:5800 AMERICAN BLVD W APT 301
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1476
Mailing Address - Country:US
Mailing Address - Phone:608-346-7577
Mailing Address - Fax:
Practice Address - Street 1:14635 PENNOCK AVE STE 200
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-6587
Practice Address - Country:US
Practice Address - Phone:952-432-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor