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NPI Code Detail

MEDICARE: KAYLA NOELLE HAYNIE PTA

MEDICARE: KAYLA NOELLE HAYNIE PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2306604538VA

General Provider Information

NPI Number : 1134806839
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA NOELLE HAYNIE PTA
Provider Business Mailing Address
First Line : PO BOX 283
Second Line :
City : BURGESS
State : VA
Zip : 22432-0283
Country : US
Telephone Number : 804-761-1082
Fax Number :
Provider Business Practice Location Address
First Line : 2400 MCKINNEY BLVD
Second Line :
City : COLONIAL BEACH
State : VA
Zip : 22443-1237
Country : US
Telephone Number : 804-224-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2023
Last Update Date : 07/03/2023

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Directions to “ KAYLA NOELLE HAYNIE PTA” Practice Location

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