Individual
KYLE NEWCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, CSCS
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Mailing address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11160-24
WI
Other
Enumeration date
06/21/2012
Last updated
12/06/2012
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