MEDICARE: KAYLA ALBERS

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	PT018303	OH

General Provider Information

NPI Number	:	1861011827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA ALBERS

Provider Business Mailing Address
First Line	:	169 S LINCOLN ST
Second Line	:
City	:	MINSTER
State	:	OH
Zip	:	45865-1240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1067 HAGER ST
Second Line	:
City	:	SAINT MARYS
State	:	OH
Zip	:	45885-2422
Country	:	US
Telephone Number	:	419-394-9514
Fax Number	:

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

Provider Enumeration Date	:	04/10/2020
Last Update Date	:	04/10/2020

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