Individual
KYLEN MATTHEW GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
14020 OLD STATE RD, EVANSVILLE, IN 47725-1121
(812) 469-4770
Mailing address
3900 CANYON ROCK CT, EVANSVILLE, IN 47725-8274
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010536A
IN
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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