Individual
KYLIE JACQUELINE IRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2621 15TH AVE S, GREAT FALLS, MT 59405-5201
(406) 455-5000
Mailing address
1706 12TH AVE S, GREAT FALLS, MT 59405-4863
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2453
MT
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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