NPI 1003304080

Kyle Stephen Brabaw, PTDPT

Practitioner Physical Therapist Fort Polk, LA

Practice location

Address: 1585 Third Street, Fort Polk, LA 71459-5536
Phone: (337) 531-3203
Mailing address: 2637 N Stark Rd, Midland, MI 48642-9464

Registered specialties (3)

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 294643 (CA)

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Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 2305211419 (VA)

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 5501018291 (MI)

Registry record

NPI: 1003304080
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2018
Record last updated: 5 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.