Provider Demographics
NPI:1548788086
Name:SRAMEK, KYLIE NICOLE (DOCTOR OF PT)
Entity Type:Individual
Prefix:MS
First Name:KYLIE
Middle Name:NICOLE
Last Name:SRAMEK
Suffix:
Gender:F
Credentials:DOCTOR OF PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4543 WEST 226 STREET
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126
Mailing Address - Country:US
Mailing Address - Phone:440-539-5575
Mailing Address - Fax:
Practice Address - Street 1:201 FRONT ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017
Practice Address - Country:US
Practice Address - Phone:440-260-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017121208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation