Healthcare Provider Details

I. General information

NPI: 1396483939
Provider Name (Legal Business Name): KYLIE MORRISSEY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KYLIE BEHRENS DPT

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 SW ORALABOR RD STE F
ANKENY IA
50023-7147
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 515-963-5550
  • Fax: 515-963-5551
Mailing address:
  • Phone: 630-575-6250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number112595
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: