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NPI Code Detail

MEDICARE: KYRA ROBB PT, DPT

MEDICARE: KYRA ROBB PT, DPT
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
1225100000XPhysical TherapistPT292211CA

General Provider Information

NPI Number : 1376085688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYRA ROBB PT, DPT
Provider Business Mailing Address
First Line : 29050 MILLER RD
Second Line :
City : VALLEY CENTER
State : CA
Zip : 92082-5801
Country : US
Telephone Number : 760-489-1969
Fax Number :
Provider Business Practice Location Address
First Line : 457 N ELM ST
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3001
Country : US
Telephone Number : 760-489-1969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2016
Last Update Date : 11/17/2016

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