Provider Demographics
NPI:1033697636
Name:WHITE, KYLE A (DPT)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:A
Last Name:WHITE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CROSSING LN STE 1
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3778
Mailing Address - Country:US
Mailing Address - Phone:540-463-5888
Mailing Address - Fax:540-463-4406
Practice Address - Street 1:25 CROSSING LN STE 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3778
Practice Address - Country:US
Practice Address - Phone:540-463-5888
Practice Address - Fax:540-463-4406
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA305212246208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation