Provider Demographics
NPI:1619359296
Name:MCAMIS, KAYLA
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MCAMIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S DOUGLAS HWY
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4924
Mailing Address - Country:US
Mailing Address - Phone:307-682-2632
Mailing Address - Fax:307-682-2610
Practice Address - Street 1:1001 S DOUGLAS HWY
Practice Address - Street 2:SUITE B-4
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4924
Practice Address - Country:US
Practice Address - Phone:307-682-2632
Practice Address - Fax:307-682-2610
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist