Stevenson, Kyle R

Stevenson, Kyle R is an individual health care provider with primary practice located at 1630 Commanche Ave , Green Bay WI 54313-5753. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Stevenson, Kyle R can be contacted via phone (920) 430-4750.

Contact Information

Primary practice address
1630 Commanche Ave Green Bay WI 54313-5753
Phone: (920) 430-4750
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2810 Wisconsin

Profile Details

NPI number 1568447001
LBN Legal business name Stevenson, Kyle R
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Mar 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568447001 NPPES
Wisconsin Other 2810-024 LICENSE

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