Provider Demographics
NPI:1578995452
Name:BAIOCCHI, KYLE GREGORY (DPT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:GREGORY
Last Name:BAIOCCHI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-541-1974
Mailing Address - Fax:
Practice Address - Street 1:2250 MILLENNIUM WAY STE 400
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1488
Practice Address - Country:US
Practice Address - Phone:717-732-8131
Practice Address - Fax:717-790-9923
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist