Provider Demographics
NPI:1942439724
Name:HALL, KYLE L (DPT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:710 COMMERCE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4925
Mailing Address - Country:US
Mailing Address - Phone:651-968-5042
Mailing Address - Fax:651-968-5904
Practice Address - Street 1:1661 SAINT ANTHONY AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-7632
Practice Address - Country:US
Practice Address - Phone:651-968-5335
Practice Address - Fax:651-730-3989
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2015-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN83902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic