Provider Demographics
NPI:1053558692
Name:JEUDEVINE, LINDSEY KYLE (DC)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:KYLE
Last Name:JEUDEVINE
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 1:3461 GOLDENWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4916
Mailing Address - Country:US
Mailing Address - Phone:850-516-9155
Mailing Address - Fax:
Practice Address - Street 1:208 S ALCANIZ ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6012
Practice Address - Country:US
Practice Address - Phone:850-607-2105
Practice Address - Fax:850-607-6498
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor