Individual
KYLE MICHAEL SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
531 HANNAH ST, CLEARFIELD, PA 16830-1245
(814) 765-2261
Mailing address
235 HARRIS AVE, BOALSBURG, PA 16827-1239
(814) 409-8652
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1171989
PA
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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