Individual
DR. KYLE STEPHEN BRABAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1585 THIRD STREET, FORT POLK, LA 71459-5536
(337) 531-3203
Mailing address
2637 N STARK RD, MIDLAND, MI 48642-9464
(989) 513-5002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305211419
VA
225100000X
Physical Therapist
Primary
294643
CA
225100000X
Physical Therapist
5501018291
MI
Other
Enumeration date
04/25/2018
Last updated
04/05/2022
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