MEDICARE: KYLIE KEY 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
1	225100000X	Physical Therapist	007476	KY

General Provider Information

NPI Number	:	1720894033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE KEY PT, DPT

Provider Business Mailing Address
First Line	:	10201 VALLEY FARMS BLVD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40272-3284
Country	:	US
Telephone Number	:	484-270-4371
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 VALLEY FARMS BLVD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40272-3284
Country	:	US
Telephone Number	:	484-270-4371
Fax Number	:

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

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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