Individual
KYLE HAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 34TH STREET, SAN DIEGO, CA 92102
(619) 232-1058
Mailing address
111 WELLMORE DR., TEGA CAY, SC 29708
(803) 835-7000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3667
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518416007
—
SC
Enumeration date
09/26/2016
Last updated
06/16/2018
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