Provider Demographics
NPI:1184976037
Name:DRAGON, KALYN MCNAIR (DPT)
Entity type:Individual
Prefix:
First Name:KALYN
Middle Name:MCNAIR
Last Name:DRAGON
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 1:11845 RIVER ESTATES CIR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-8603
Mailing Address - Country:US
Mailing Address - Phone:601-916-6090
Mailing Address - Fax:
Practice Address - Street 1:11845 RIVER ESTATES CIR
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-8603
Practice Address - Country:US
Practice Address - Phone:601-916-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT46902251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics