MEDICARE: KYLEIGH HAMILTON

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1679042386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLEIGH HAMILTON

Provider Business Mailing Address
First Line	:	1160 SYLVAN RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5769
Country	:	US
Telephone Number	:	610-431-9563
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 SYLVAN RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5769
Country	:	US
Telephone Number	:	610-431-9563
Fax Number	:

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

Provider Enumeration Date	:	11/26/2018
Last Update Date	:	11/26/2018

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Directions to “ KYLEIGH HAMILTON ” Practice Location

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