Kayla Christine Vickers, PT, DPT, CMTPT
Physical Therapist in Jacksonville, IL. Individual provider (NPI-1).
NPI number1164053526
StatusActive
Last updated in NPPESFeb 3, 2020
Details
- NPI
- 1164053526
- Entity type
- Individual (NPI-1)
- Name
- Kayla Christine Vickers
- Credential
- PT, DPT, CMTPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 3, 2020
- Certification date
- Feb 3, 2020
- Last updated
- Feb 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 070022185 | IL | Yes |
Practice location
1600 W Walnut StJacksonville, IL 62650-1136
Phone 217-245-9541
Mailing address
1715 Plover RdSpringfield, IL 62711-7925
Phone 217-836-4320
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