Individual
KYLE HIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2940 E BANNER GATEWAY DR STE 200, GILBERT, AZ 85234-2171
(480) 964-2908
Mailing address
4222 E THOMAS RD STE 250, PHOENIX, AZ 85018-7619
(602) 385-2115
(602) 648-5445
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13219
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13219
LICENSE
AZ
Enumeration date
08/14/2017
Last updated
08/14/2017
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