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Individual

MR. KYLE MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
150 OVERLOOK AVE, APT 1A, PEEKSKILL, NY 10566-3004
(914) 484-8246
Mailing address
PO BOX 736, MOHEGAN LAKE, NY 10547-0736
(914) 484-8246

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
013224-1
NY

Other

Enumeration date
07/10/2007
Last updated
03/11/2009
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