Kyle William Wisniewski, PTA
Physical Therapy Assistant in Shoreline, WA. Individual provider (NPI-1).
NPI number1013663566
StatusActive
Last updated in NPPESFeb 23, 2022
Details
- NPI
- 1013663566
- Entity type
- Individual (NPI-1)
- Name
- Kyle William Wisniewski
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 23, 2022
- Certification date
- Feb 23, 2022
- Last updated
- Feb 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 61205687 | WA | Yes |
Practice location
1227 N 205th StShoreline, WA 98133-3214
Phone 206-546-2220
Mailing address
11716 Greenwood Ave N Apt 301Seattle, WA 98133-8162
Phone 206-349-3827
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All 15 Physical Therapy Assistant providers in Shoreline · All 1,513 providers in Shoreline
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