Individual
KYLE LEE DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
504 E TELEGRAPH ST UNIT 81, WASHINGTON, UT 84780-8851
(210) 284-4622
Mailing address
504 E TELEGRAPH ST UNIT 81, WASHINGTON, UT 84780-8851
(210) 284-4622
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0131000877
VA
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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