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General NPI Number Information
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NPI Number | 1336385863
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Entity Type | Individual
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Provider Name | KYLE AUSTIN KRABILL C. PED
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Gender | Male
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 7201 FRIENDSHIP RD
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City | PITTSVILLE
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State | MD
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Zip | 21850-2039
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Country | US
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Telephone | 410-835-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 3609 SHEEPHOUSE RD
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City | POCOMOKE CITY
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State | MD
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Zip | 21851-2307
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Country | US
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Telephone | 410-726-4637
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | CPED2960
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License Number State | MD
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