Healthcare Provider Details

I. General information

NPI: 1588017339
Provider Name (Legal Business Name): KYRA MARIE MESA MARTINEZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KYRA MARIE WEEMS

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 STELZER RD STE 240
COLUMBUS OH
43219-3676
US

IV. Provider business mailing address

340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US

V. Phone/Fax

Practice location:
  • Phone: 614-827-1300
  • Fax: 614-827-0877
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016363
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: