Provider Demographics
NPI:1245055771
Name:ART-JOHNSON, KYLIE RENE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:RENE
Last Name:ART-JOHNSON
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 1:36295 COUNTY ROAD 70
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:OH
Mailing Address - Zip Code:43844-9789
Mailing Address - Country:US
Mailing Address - Phone:740-552-1171
Mailing Address - Fax:
Practice Address - Street 1:100 S WHITEWOMAN ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1068
Practice Address - Country:US
Practice Address - Phone:740-622-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0199182251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics