Individual
KYLE LYNDON WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
111 HIGHWAY 15 S, PONTOTOC, MS 38863-2628
(662) 586-2444
Mailing address
258 S MAIN ST, PONTOTOC, MS 38863-3305
(662) 419-1979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6900
MS
390200000X
Student in an Organized Health Care Education/Training Program
PT6900
MS
Other
Enumeration date
07/09/2020
Last updated
08/13/2020
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