Provider Demographics
NPI:1417944711
Name:KAHL, ALICE BARRON (PT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:BARRON
Last Name:KAHL
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 DONEGAL DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6056
Mailing Address - Country:US
Mailing Address - Phone:949-533-5370
Mailing Address - Fax:
Practice Address - Street 1:1437 DONEGAL DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6056
Practice Address - Country:US
Practice Address - Phone:949-533-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA158422251S0007X
FL370572251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports