# KYLE MELLINGER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790297950
- **Gender:** Man
- **Credential:** DPT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 2305211157 | VA | — |
| 225100000X | Physical Therapist | 26712 | MD | Yes |
| 225100000X | Physical Therapist | 8617 | SC | — |

## Other

- **Enumeration date:** 10/27/2017
- **Last updated:** 02/05/2024