Most Relevant Information
Provider Data
| NPI Number: | 1003432717 |
| Provider Name: | KYLE EGERDAL |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/18/2020 |
| Last Updated: | 06/10/2024 |
Provider Practice Location
6709 RAYMOND RD STE 174
MADISON
WI
537193943
Practice Location Phone/Fax
| Phone: | 6082058587 |
| Fax: |
Provider Mailing Location
6709 RAYMOND RD STE 174
MADISON
WI
537193943
Provider Mailing Phone/Fax
| Phone: | 6082058587 |
| Fax: |