Individual
KYLE BURT SEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 877-5350
Mailing address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 877-5350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/27/2021
Last updated
06/27/2022
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