Most Relevant Information
Provider Data
NPI Number: | 1003304080 |
Provider Name: | KYLE STEPHEN BRABAW PT, DPT |
Entity Type: | Individual |
Taxonomy Code: | 225100000X |
Specialty: | Physical Therapist |
License Number: | 2305211419 |
Most Important Dates
Enumeration Date: | 04/25/2018 |
Last Updated: | 04/05/2022 |
Provider Practice Location
1585 THIRD STREET
FORT POLK
LA
714595536
Practice Location Phone/Fax
Phone: | 3375313203 |
Fax: |
Provider Mailing Location
2637 N STARK RD
MIDLAND
MI
486429464
Provider Mailing Phone/Fax
Phone: | 9895135002 |
Fax: |