Individual
CYNTHIA KYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3317 GORDON HIGHWAY, GROVETOWN, PA 19382
(111) 111-1111
Mailing address
3317 GORDON HIGHWAY, GROVETOWN, PA 19382
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
22 RESPIRATORY, DEVELOPMENTAL SERVICE PROVIDERS
GA
Enumeration date
04/02/2012
Last updated
05/01/2013
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