Individual
KYLE VAROSKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
4411 S ADAMS ST, MARION, IN 46953-5349
(765) 674-4445
(765) 674-3577
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4863
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811014681
—
IN
Enumeration date
07/31/2017
Last updated
01/23/2020
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