Individual
KYLA JO TIRTONEGORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1171 TOWNE ST, CINCINNATI, OH 45216-2227
(513) 242-1360
Mailing address
1171 TOWNE ST, CINCINNATI, OH 45216-2227
(513) 242-1360
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
07698
OH
225200000X
Physical Therapy Assistant
2078125
TX
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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