Doctor Name: | KYLE WILLIAMS |
NPI Number: | 1013336841 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.AC |
License Number: | MSG005663 |
Business Practice Address: | 32 E Front St Media, PA - 190632912 |
Business Phone Number: | 6105659642 |
Business Fax Number: | |
Mailing Address: | 32 E Front St, MEDIA |
State: | PA |
Postal Code: | 190632912 |
Phone Number: | 6105659642 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2014 |
NPI Last Update Date: | 04/30/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MSG005663 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |