Provider Demographics
NPI:1780202614
Name:STANNARD, KAYLA (DPT)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:STANNARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DYLAN
Other - Middle Name:
Other - Last Name:STANNARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:181 HAWTHORNE AVE LOWR APT
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-3015
Mailing Address - Country:US
Mailing Address - Phone:315-751-6436
Mailing Address - Fax:
Practice Address - Street 1:5544 MAIN ST # 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5406
Practice Address - Country:US
Practice Address - Phone:716-580-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist