Provider Demographics
NPI:1598742363
Name:WELK, KYLE B (PT)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:B
Last Name:WELK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:551 N HILLSIDE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4923
Mailing Address - Country:US
Mailing Address - Phone:316-962-8043
Mailing Address - Fax:316-962-8096
Practice Address - Street 1:551 N HILLSIDE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4923
Practice Address - Country:US
Practice Address - Phone:316-962-8043
Practice Address - Fax:316-962-8096
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS11-03452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist