Provider Demographics
NPI:1154853596
Name:MAURER, KAYLA ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ANN
Last Name:MAURER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 WEST HURON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413
Mailing Address - Country:US
Mailing Address - Phone:989-269-2700
Mailing Address - Fax:989-269-2705
Practice Address - Street 1:267 E. SANILAC RD.
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471
Practice Address - Country:US
Practice Address - Phone:810-648-6300
Practice Address - Fax:810-648-6512
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004604225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant