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General NPI Number Information
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NPI Number | 1407774441
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Entity Type | Individual
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Provider Name | KYLE C KEITH PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 500 GROVE ST STE 100
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City | HADDON HEIGHTS
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State | NJ
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Zip | 08035-1761
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Country | US
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Telephone | 856-617-0175
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Fax |
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Provider Business Mailing Address
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Address Line | 124 S MAIN ST
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City | ELMER
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State | NJ
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Zip | 08318-2233
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Country | US
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Telephone | 609-850-1367
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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 |
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License Number State |
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