Individual
KYLE KIRST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
377 W RIVER WOODS PKWY, GLENDALE, WI 53212-1088
(414) 964-4777
Mailing address
610 COUNTY ROAD D, BELGIUM, WI 53004-9722
(262) 365-4595
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6482-26
WI
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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