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Individual

MR. KYLE SPRATFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5570 MAIN ST, WILLIAMSVILLE, NY 14221-5477
(888) 317-0494
Mailing address
101 REVERE RD, GRAND ISLAND, NY 14072-2815
(716) 512-5256

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
008655-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A08234873
INDEPENDENT HEALTH
NY
Enumeration date
06/09/2014
Last updated
06/09/2014
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