Provider Demographics
NPI:1750707352
Name:WOODS, KYLE
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARKET ST STE 4103
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-5636
Mailing Address - Country:US
Mailing Address - Phone:828-877-2110
Mailing Address - Fax:828-707-9452
Practice Address - Street 1:4 MARKET ST STE 4103
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-5636
Practice Address - Country:US
Practice Address - Phone:828-877-2110
Practice Address - Fax:828-707-9452
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4573225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant