Provider Demographics
NPI:1003665910
Name:MCGILL, KYLE THOMAS (DPT)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:THOMAS
Last Name:MCGILL
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 OLD GEORGETOWN RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-6133
Mailing Address - Country:US
Mailing Address - Phone:301-657-9876
Mailing Address - Fax:
Practice Address - Street 1:7500 OLD GEORGETOWN RD STE 301
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6133
Practice Address - Country:US
Practice Address - Phone:301-657-9876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29910225100000X
DCCP031384T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist