Provider Demographics
NPI:1730459256
Name:HULL, KAYLA LYNN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:LYNN
Last Name:HULL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 E ORANGE ST
Mailing Address - Street 2:#8
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5494
Mailing Address - Country:US
Mailing Address - Phone:863-450-5104
Mailing Address - Fax:
Practice Address - Street 1:112 E PINE ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-4965
Practice Address - Country:US
Practice Address - Phone:863-397-7531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL62615225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist