Individual
MRS. KYLA GELINA SULCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1191 FORTUNE BLVD STE 2, SHILOH, IL 62269-7474
(618) 607-0061
(618) 615-4290
Mailing address
1191 FORTUNE BLVD STE 2, SHILOH, IL 62269-7474
(618) 607-0061
(618) 615-4290
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.007051
IL
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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