Provider Demographics
NPI:1235697855
Name:DRESSEL, KAYTELYN (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:KAYTELYN
Middle Name:
Last Name:DRESSEL
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 E GLEN DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13981 SOCORRO RD
Practice Address - Street 2:
Practice Address - City:SAN ELIZARIO
Practice Address - State:TX
Practice Address - Zip Code:79849-7984
Practice Address - Country:US
Practice Address - Phone:915-872-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT61972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer