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NPI Code Detail

MEDICARE: KYLE F SAMPSON

MEDICARE:   KYLE F SAMPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1518434125
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE F SAMPSON
Provider Business Mailing Address
First Line : 600 OAKMONT LN STE 600C
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5548
Country : US
Telephone Number : 630-590-4029
Fax Number :
Provider Business Practice Location Address
First Line : 315 N MILWAUKEE ST
Second Line :
City : WATERFORD
State : WI
Zip : 53185-4432
Country : US
Telephone Number : 262-514-2700
Fax Number : 262-514-3003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2018
Last Update Date : 11/01/2018

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Directions to “ KYLE F SAMPSON ” Practice Location

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