Provider Demographics
NPI:1851911838
Name:LYNCH, KAYTE LEA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KAYTE
Middle Name:LEA
Last Name:LYNCH
Suffix:
Gender:F
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 1:1809 W 25TH CT
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-6948
Mailing Address - Country:US
Mailing Address - Phone:318-349-0290
Mailing Address - Fax:
Practice Address - Street 1:1809 W 25TH CT
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-6948
Practice Address - Country:US
Practice Address - Phone:318-349-0290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16727225100000X
OK6082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist