| Doctor Name: | KYLEE MICHELLE PERMANN |
| NPI Number: | 1003279357 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OTD, OTR/L |
| License Number: | 1559 |
| Business Practice Address: | 560 Memorial Dr Ste B Pocatello, ID - 832014073 |
| Business Phone Number: | 2084780258 |
| Business Fax Number: | 2082697336 |
| Mailing Address: | 560 Memorial Dr Ste B, POCATELLO |
| State: | ID |
| Postal Code: | 832014073 |
| Phone Number: | 2084780258 |
| Fax Number: | 2082697336 |
| NPI Enumeration Date: | 04/04/2016 |
| NPI Last Update Date: | 04/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225XH1200X |
| License Number: | 1559 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Occupational Therapist |
| Taxonomy Specialization: | Hand |
| Taxonomy Definition: | |