MEDICARE: KAYLEE MICHELLE POBOCIK PT, ATC

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
1	225100000X	Physical Therapist	5501019510	MI
2	225100000X	Physical Therapist	4619	NH

General Provider Information

NPI Number	:	1427683960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE MICHELLE POBOCIK PT, ATC

Provider Business Mailing Address
First Line	:	24 HIGH ST
Second Line	:
City	:	MEREDITH
State	:	NH
Zip	:	03253-5910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 COMMERCE PARK NORTH
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-6905
Country	:	US
Telephone Number	:	603-267-0432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	09/01/2022

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