MEDICARE: KYLE MEDEARIS MS OTRL

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	5201008742	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MI7576007	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1487087300	OTHER		NPI

General Provider Information

NPI Number	:	1780081075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE MEDEARIS MS OTRL

Provider Business Mailing Address
First Line	:	415 MUNSON AVE STE 101
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3059
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 MUNSON AVE STE 101
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3059
Country	:	US
Telephone Number	:	231-486-6330
Fax Number	:

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

Provider Enumeration Date	:	12/02/2014
Last Update Date	:	04/18/2018

Similar Medicare Providers

1831215961 — PROF. SARAH JEAN HEHIR P.T.
Practice Location Address:

415 MUNSON AVE STE 101
TRAVERSE CITY, MI
49686-3059

Practice Phone: 231-486-6330
Practice Fax: 231-486-6329

1215313739 — WENDY WECKSTEIN PT
Practice Location Address:

415 MUNSON AVE , STE 103 & 104
TRAVERSE CITY, MI
49686-3059

Practice Phone: 231-486-6330
Practice Fax:

1902272446 — APRIL BLUCK
Practice Location Address:

415 MUNSON AVE , STE 103
TRAVERSE CITY, MI
49686-3059

Practice Phone: 800-968-6866
Practice Fax:

1770956104 — ELIZABETH HYEK-GOTTS
Practice Location Address:

415 MUNSON AVE , STE 103
TRAVERSE CITY, MI
49686-3059

Practice Phone: 800-968-6866
Practice Fax:

1588021885 — ANN REICHERT
Practice Location Address:

415 MUNSON AVE
TRAVERSE CITY, MI
49686-3059

Practice Phone: 231-486-6330
Practice Fax:

1043679269 — SYDNEY STILES
Practice Location Address:

415 MUNSON AVE
TRAVERSE CITY, MI
49686-3059

Practice Phone: 231-486-6330
Practice Fax:

Directions to “ KYLE MEDEARIS MS OTRL” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.