Provider Demographics
NPI:1760811772
Name:TEMPLE, KITTY LYNN (LMT)
Entity Type:Individual
Prefix:MS
First Name:KITTY
Middle Name:LYNN
Last Name:TEMPLE
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 1:5156 BLAZER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-7317
Mailing Address - Country:US
Mailing Address - Phone:614-889-7360
Mailing Address - Fax:614-889-7358
Practice Address - Street 1:5156 BLAZER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-7317
Practice Address - Country:US
Practice Address - Phone:614-889-7360
Practice Address - Fax:614-889-7358
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.009379172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist