Provider Demographics
NPI:1346790656
Name:WINLING, KAYLEIGH (PTA)
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:WINLING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MINNEAPOLIS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MI
Mailing Address - Zip Code:49837-2060
Mailing Address - Country:US
Mailing Address - Phone:906-428-3085
Mailing Address - Fax:906-428-3086
Practice Address - Street 1:2001 MINNEAPOLIS AVE STE C
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MI
Practice Address - Zip Code:49837-2060
Practice Address - Country:US
Practice Address - Phone:906-428-3085
Practice Address - Fax:906-428-3086
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004044225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant