Provider Demographics
NPI:1174037188
Name:ZOSKE, KYLEE KAE
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:KAE
Last Name:ZOSKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 W BENTON ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4949
Mailing Address - Country:US
Mailing Address - Phone:641-858-6538
Mailing Address - Fax:
Practice Address - Street 1:1848 W BENTON ST UNIT 202
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4949
Practice Address - Country:US
Practice Address - Phone:641-858-6538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer