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General NPI Number Information
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NPI Number | 1689059685
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Entity Type | Individual
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Provider Name | AMY KILE PTA
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Gender | Female
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 6200 XERXES AVE S
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City | EDINA
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State | MN
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Zip | 55423-1033
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Country | US
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Telephone | 612-202-7317
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Fax |
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Provider Business Mailing Address
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Address Line | 6810 W 24TH ST
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-2807
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | CA
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