Provider Demographics
NPI:1558424028
Name:HOUNSHELL, KYLA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KYLA
Middle Name:MARIE
Last Name:HOUNSHELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KYLA
Other - Middle Name:QUILLIN
Other - Last Name:HOUNSHELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:5920 HIGHWAY 126
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-3950
Mailing Address - Country:US
Mailing Address - Phone:423-367-8282
Mailing Address - Fax:
Practice Address - Street 1:113 CASSELL DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3775
Practice Address - Country:US
Practice Address - Phone:423-246-7240
Practice Address - Fax:423-246-8967
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000005447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist