Provider Demographics
NPI:1053623447
Name:COFFEY, KYLE FRANCIS (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:FRANCIS
Last Name:COFFEY
Suffix:
Gender:M
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 1:10 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2008
Mailing Address - Country:US
Mailing Address - Phone:508-981-1475
Mailing Address - Fax:
Practice Address - Street 1:10 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2008
Practice Address - Country:US
Practice Address - Phone:508-981-1475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19132225100000X
NH3695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist