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General NPI Number Information
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NPI Number | 1215916630
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Entity Type | Individual
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Provider Name | MICHELLE RAE KASTLER PT
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Gender | Female
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 149 HART ST 82 MEDICAL GROUP
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City | SHEPPARD AFB
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State | TX
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Zip | 76311-3477
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Country | US
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Telephone | 940-676-3873
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Fax | 940-676-3335
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Provider Business Mailing Address
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Address Line | 109 FALCON BLVD
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City | SHEPPARD AFB
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State | TX
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Zip | 76311-1005
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Country | US
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Telephone | 940-676-3873
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Fax | 940-676-3335
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 01800
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License Number State | IA
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