Individual
JUSTIN WAYNE KYSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2301 RAINBOW DR, GADSDEN, AL 35901-5517
(256) 543-3467
Mailing address
325 COAL ST, SANDROCK, AL 35983-4385
(256) 844-0723
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA9612
AL
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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