Provider Demographics
NPI:1417518994
Name:RENTSCHLER, KYLE MICHAEL (LAT, ATC, MS)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:MICHAEL
Last Name:RENTSCHLER
Suffix:
Gender:M
Credentials:LAT, ATC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 INTEGRA BREEZE LN UNIT 101
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5586
Mailing Address - Country:US
Mailing Address - Phone:610-413-1081
Mailing Address - Fax:
Practice Address - Street 1:801 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4715
Practice Address - Country:US
Practice Address - Phone:386-322-6272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL-26832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer