Provider Demographics
NPI:1699818203
Name:SPALDING, KYLENE ANN (PT)
Entity Type:Individual
Prefix:
First Name:KYLENE
Middle Name:ANN
Last Name:SPALDING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4372 R E SMITH DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-9200
Mailing Address - Country:US
Mailing Address - Phone:513-258-3865
Mailing Address - Fax:
Practice Address - Street 1:3075 HAMILTON MASON ROAD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011
Practice Address - Country:US
Practice Address - Phone:513-454-3000
Practice Address - Fax:513-454-3033
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 010900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist