Provider Demographics
NPI:1689951535
Name:KILTY, TARYN L (DPT)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:L
Last Name:KILTY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:L
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1951 BLUEGRASS CIR
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7355
Mailing Address - Country:US
Mailing Address - Phone:307-773-8533
Mailing Address - Fax:307-635-7578
Practice Address - Street 1:1913 MAIN ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-2722
Practice Address - Country:US
Practice Address - Phone:307-630-0740
Practice Address - Fax:307-222-6208
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3054225100000X
WY1404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist