Most Relevant Information
Provider Data
| NPI Number: | 1003326125 |
| Provider Name: | KYLE WAYNE SOFIA |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/03/2017 |
| Last Updated: | 10/03/2017 |
Provider Practice Location
1910 SHAFFER ST
KALAMAZOO
MI
490481604
Practice Location Phone/Fax
| Phone: | 2693829820 |
| Fax: | 2693457190 |
Provider Mailing Location
1910 SHAFFER ST
KALAMAZOO
MI
490481604
Provider Mailing Phone/Fax
| Phone: | 2693829820 |
| Fax: | 2693457190 |