Individual
DR. KYLE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
300 S SAINT LOUIS BLVD, SOUTH BEND, IN 46617-3043
(574) 234-1059
Mailing address
1649 RIVERSIDE DR APT A, SOUTH BEND, IN 46616-1630
(765) 620-3771
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05014450A
IN
225100000X
Physical Therapist
99105074A
IN
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
08/15/2017
Last updated
12/03/2021
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