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Individual

KYLE ALEXANDER MASCOLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
2990 HOLME AVE, PHILADELPHIA, PA 19136-1830
(215) 335-2100
Mailing address
1000 N MARSHALL ST UNIT 1, PHILADELPHIA, PA 19123-1309
(732) 841-0037

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
029604
PA
208100000X
Physical Medicine & Rehabilitation Physician
40QA02016100
NJ

Other

Enumeration date
03/10/2022
Last updated
03/10/2022
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