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General NPI Number Information
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NPI Number | 1306804042
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Entity Type | Individual
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Provider Name | KYLA SAND PT
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1808 MAIN RD
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City | TIVERTON
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State | RI
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Zip | 02878-4625
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Country | US
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Telephone | 401-625-9855
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Fax | 401-625-9856
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Provider Business Mailing Address
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Address Line | 9 BARNEY CT APT R
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City | NEWPORT
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State | RI
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Zip | 02840-2919
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Country | US
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Telephone | 401-595-2944
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Fax |
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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 | PT01939
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License Number State | RI
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