Individual
KYLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6485 BEARD AVE, COCOA, FL 32927-4255
(407) 733-1767
Mailing address
6485 BEARD AVE, COCOA, FL 32927-4255
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28941
FL
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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