Individual
KYLE SCHIMMOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0000000826
TN
363A00000X
Physician Assistant
MA057282
PA
363AS0400X
Surgical Physician Assistant
Primary
3291
SC
Other
Enumeration date
02/27/2007
Last updated
07/20/2022
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