Provider Demographics
NPI:1013755800
Name:OTOOLE, KYRA ZHUYI (DPT)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:ZHUYI
Last Name:OTOOLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LOWER STATE RD STE 308
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1201
Mailing Address - Country:US
Mailing Address - Phone:215-987-9898
Mailing Address - Fax:215-997-9899
Practice Address - Street 1:1501 LOWER STATE RD STE 308
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1201
Practice Address - Country:US
Practice Address - Phone:215-997-9898
Practice Address - Fax:215-997-9899
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist