Individual
KYLE CONNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
530 BOGACHIEL WAY, FORKS, WA 98331-9120
(360) 374-6271
Mailing address
6433 CASPER DR N, KEIZER, OR 97303-7430
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60914326
WA
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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