Basic Information
Provider Information
NPI: 1962576371
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUHLMAN
FirstName: KYLE
MiddleName: DAVID
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 4515 C AVE NE
Address2:  
City: CEDAR RAPIDS
State: IA
PostalCode: 524023115
CountryCode: US
TelephoneNumber: 3193504330
FaxNumber:  
Practice Location
Address1: 2055 KIMBALL AVE
Address2: SUITE 300
City: WATERLOO
State: IA
PostalCode: 507025014
CountryCode: US
TelephoneNumber: 3192722500
FaxNumber: 3192722503
Other Information
ProviderEnumerationDate: 11/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X00914IAY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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