MEDICARE: KYRA MARIE MESA MARTINEZ DPT

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
1	225100000X	Physical Therapist	PT016363	OH

General Provider Information

NPI Number	:	1588017339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA MARIE MESA MARTINEZ DPT

Provider Business Mailing Address
First Line	:	340 POLARIS PKWY
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-7971
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 STELZER RD STE 240
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3676
Country	:	US
Telephone Number	:	614-827-1300
Fax Number	:	614-827-0877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	12/08/2025

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