Provider Demographics
NPI:1356049530
Name:EYNON, KYLIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:EYNON
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 1:230 S CHERRYWOOD DR UNIT 204
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2093
Mailing Address - Country:US
Mailing Address - Phone:713-851-1303
Mailing Address - Fax:
Practice Address - Street 1:818 W SOUTH BOULDER RD UNIT 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2416
Practice Address - Country:US
Practice Address - Phone:303-604-6441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0018929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist