Individual
KYLE MCKIBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
W173N10915 BERNIES WAY, GERMANTOWN, WI 53022-4043
(262) 509-3300
Mailing address
924 E JUNEAU AVE APT 817, MILWAUKEE, WI 53202-2748
(513) 324-4122
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15103-24
WI
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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