Provider Demographics
NPI:1386629384
Name:WILLIAMS, KYRA M (PT)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:321 CHESSBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1525
Mailing Address - Country:US
Mailing Address - Phone:412-831-0180
Mailing Address - Fax:
Practice Address - Street 1:159 WATERDAM RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2576
Practice Address - Country:US
Practice Address - Phone:724-942-1511
Practice Address - Fax:724-942-1513
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist