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General NPI Number Information
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NPI Number | 1891140281
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Entity Type | Individual
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Provider Name | KYLE ZEISZLER CMT ATC
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Gender | Male
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 31 NAVAHO AVE
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City | MANKATO
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State | MN
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Zip | 56001-4812
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Country | US
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Telephone | 701-391-1215
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Fax |
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Provider Business Mailing Address
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Address Line | 527 GARY AVE
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City | BISMARCK
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State | ND
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Zip | 58501-9999
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Country | US
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Telephone | 701-391-1215
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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