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NPI Code Detail

MEDICARE: KYLIE SANDERSON OTR/L

MEDICARE: KYLIE SANDERSON 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 Therapist299917KY

General Provider Information

NPI Number : 1235069642
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE SANDERSON OTR/L
Provider Business Mailing Address
First Line : 5224 EVA DR
Second Line :
City : PADUCAH
State : KY
Zip : 42001-9610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3235 OLIVET CHURCH RD STE D
Second Line :
City : PADUCAH
State : KY
Zip : 42001-9545
Country : US
Telephone Number : 270-443-5712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ KYLIE SANDERSON OTR/L” Practice Location

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