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Individual
KYLE R HIMMELREICH
Active
Individual
KYLE R HIMMELREICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT020713
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102492178-0001
—
PA
01
—
1427361971
BRAVO
PA
01
—
1427361971
BERKSHIRE
—
Enumeration date
07/26/2010
Last updated
03/22/2011
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