Provider Demographics
NPI:1245117134
Name:RAINBOW, KYRA NICOLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:NICOLE
Last Name:RAINBOW
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 WARRINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-0204
Mailing Address - Country:US
Mailing Address - Phone:405-626-0151
Mailing Address - Fax:
Practice Address - Street 1:1828 BRIDGEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3051
Practice Address - Country:US
Practice Address - Phone:208-735-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID3271168225100000X
OK6648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist