Provider Demographics
NPI:1639876998
Name:MUSSER, KYLE (PTA)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:MUSSER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:ALBURTIS
Mailing Address - State:PA
Mailing Address - Zip Code:18011-0033
Mailing Address - Country:US
Mailing Address - Phone:484-280-7355
Mailing Address - Fax:
Practice Address - Street 1:2301 CHERRY LN
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-9540
Practice Address - Country:US
Practice Address - Phone:484-526-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE012747225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant