MEDICARE: KYLIE ATKINSON

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	225X00000X	Occupational Therapist	5201008505	MI

General Provider Information

NPI Number	:	1477996437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE ATKINSON

Provider Business Mailing Address
First Line	:	14025 MARTINSVILLE RD
Second Line	:
City	:	CARLETON
State	:	MI
Zip	:	48117-9526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26336 E HURON RIVER DR
Second Line	:
City	:	FLAT ROCK
State	:	MI
Zip	:	48134-1833
Country	:	US
Telephone Number	:	734-789-8281
Fax Number	:

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

Provider Enumeration Date	:	04/09/2013
Last Update Date	:	03/23/2021

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Directions to “ KYLIE ATKINSON ” Practice Location

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