Provider Demographics
NPI:1376197889
Name:VAN ACKER, KAYLA (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:VAN ACKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:5191 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-9137
Mailing Address - Country:US
Mailing Address - Phone:231-946-1979
Mailing Address - Fax:231-946-1984
Practice Address - Street 1:5191 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685-9137
Practice Address - Country:US
Practice Address - Phone:231-946-1979
Practice Address - Fax:231-946-1984
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist