Provider Demographics
NPI:1285640482
Name:BARKER, KYLE D (ATC-LAT)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:D
Last Name:BARKER
Suffix:
Gender:M
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 1:1009 PARK PLACE TRL
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5864
Mailing Address - Country:US
Mailing Address - Phone:828-692-1333
Mailing Address - Fax:
Practice Address - Street 1:204 S KING ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5059
Practice Address - Country:US
Practice Address - Phone:828-692-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer