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NPI Code Detail

MEDICARE: KIERAN ALYSSA KOEHLER PT, DPT

MEDICARE: KIERAN ALYSSA KOEHLER 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
1225100000XPhysical Therapist2305214271VA
2225100000XPhysical Therapist299212CA

General Provider Information

NPI Number : 1871185702
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIERAN ALYSSA KOEHLER PT, DPT
Provider Business Mailing Address
First Line : 4849 STEPHANIE PL
Second Line :
City : OCEANSIDE
State : CA
Zip : 92057-3522
Country : US
Telephone Number : 267-885-9527
Fax Number :
Provider Business Practice Location Address
First Line : 713 MISSION AVE STE B
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-2852
Country : US
Telephone Number : 760-450-9597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2021
Last Update Date : 07/19/2024

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