Individual
KYLE ANDRE ST. PETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
4400 UNIVERSITY DR, MS 3A5, FAIRFAX, VA 22030
(703) 993-3280
Mailing address
11318 WESTBROOK MILL LN UNIT 103, FAIRFAX, VA 22030-5665
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
3203056420
MI
2255A2300X
Athletic Trainer
Primary
0126003666
VA
2255A2300X
Athletic Trainer
2601001718
MI
Other
Enumeration date
09/01/2015
Last updated
12/15/2025
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