Individual
MR. KYLE A VANSICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
8100 W 78TH ST STE 225, EDINA, MN 55439-2569
(952) 946-9777
Mailing address
3400 HENNEPIN AVE, MINNEAPOLIS, MN 55408-3825
(701) 306-5466
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1983
MN
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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