Provider Demographics
NPI:1740576792
Name:FOLSOM, KYLE W (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:W
Last Name:FOLSOM
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 AFRICA RD STE 160
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9830
Mailing Address - Country:US
Mailing Address - Phone:614-392-2812
Mailing Address - Fax:614-392-2816
Practice Address - Street 1:625 AFRICA RD STE 160
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9830
Practice Address - Country:US
Practice Address - Phone:614-392-2812
Practice Address - Fax:614-392-2816
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.013280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH135290OtherMEDICARE PTAN