Most Relevant Information
Provider Data
| NPI Number: | 1003595869 |
| Provider Name: | KYLE MACMILLAN |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT020401 |
Most Important Dates
| Enumeration Date: | 07/17/2023 |
| Last Updated: | 07/17/2023 |
Provider Practice Location
26202 DETROIT RD STE 216
WESTLAKE
OH
441452479
Practice Location Phone/Fax
| Phone: | 2162453496 |
| Fax: |
Provider Mailing Location
26202 DETROIT RD STE 216
WESTLAKE
OH
441452479
Provider Mailing Phone/Fax
| Phone: | 2162453496 |
| Fax: |