Provider Demographics
NPI:1174195663
Name:BURRIER, KAYLA
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:BURRIER
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 1:16007 DOOLIN CT APT 213
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-0197
Mailing Address - Country:US
Mailing Address - Phone:917-689-6694
Mailing Address - Fax:
Practice Address - Street 1:136 CORPORATE PARK DR STE A
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6960
Practice Address - Country:US
Practice Address - Phone:704-360-2796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist