Individual
KYLE PECHTOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3745 PIAZZA DR APT 210, FORT MYERS, FL 33916-8135
(814) 441-8111
Mailing address
3745 PIAZZA DR APT 210, FORT MYERS, FL 33916-8135
(814) 441-8111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17247
FL
224Z00000X
Occupational Therapy Assistant
420414
FL
Other
Enumeration date
01/11/2022
Last updated
01/14/2022
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