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NPI Code Detail

MEDICARE: MR. DAVID KYLE STICKEL OTR/L

MEDICARE: MR. DAVID KYLE STICKEL OTR/L
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
1225X00000XOccupational Therapist2197WV

General Provider Information

NPI Number : 1144932682
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID KYLE STICKEL OTR/L
Provider Business Mailing Address
First Line : 9014 WHITE WILLOW WAY
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-6121
Country : US
Telephone Number : 304-695-3322
Fax Number :
Provider Business Practice Location Address
First Line : 700 CHAPPELL RD
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2704
Country : US
Telephone Number : 304-343-1950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2022
Last Update Date : 12/15/2022

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