Provider Demographics
NPI:1003874884
Name:BARNETT, KYLE W (PT)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:W
Last Name:BARNETT
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:4750 LINDLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2428
Mailing Address - Country:US
Mailing Address - Phone:717-803-3342
Mailing Address - Fax:717-974-8743
Practice Address - Street 1:868 N US ROUTE 15
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-1617
Practice Address - Country:US
Practice Address - Phone:717-973-5813
Practice Address - Fax:717-715-1064
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT017511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03182100OtherCAPITAL BLUE CROSS
PA177124OtherMEDICARE HGS ADMINISTRATO
PA332313OtherHIGHMARK BLUE SHIELD
PACK4276OtherPALMETTO GBA RR MEDICARE
PA0068377000OtherAMERIHEALTH UNDER IBC
PA18444OtherHEALTH AMERICA
PA0068377000OtherAMERIHEALTH UNDER IBC