Provider Demographics
NPI:1477873446
Name:MILLENBINE, KYLEEN E (DPT)
Entity Type:Individual
Prefix:DR
First Name:KYLEEN
Middle Name:E
Last Name:MILLENBINE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 5 BOX 198
Mailing Address - Street 2:
Mailing Address - City:MC LEANSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62859-9208
Mailing Address - Country:US
Mailing Address - Phone:618-773-4542
Mailing Address - Fax:
Practice Address - Street 1:303 S COMMERCIAL ST STE 10
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:62946-2125
Practice Address - Country:US
Practice Address - Phone:618-252-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist