Provider Demographics
NPI:1669758892
Name:OCHSNER, KYLE JAMES (ATC, SCCC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:JAMES
Last Name:OCHSNER
Suffix:
Gender:M
Credentials:ATC, SCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 QUINCY ST NE # 1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-3624
Mailing Address - Country:US
Mailing Address - Phone:402-984-6210
Mailing Address - Fax:
Practice Address - Street 1:2305 WILLIS MILLER DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-7999
Practice Address - Country:US
Practice Address - Phone:715-386-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer