Provider Demographics
NPI:1194127589
Name:ROSSITER, KYLE LYNN (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:KYLE
Middle Name:LYNN
Last Name:ROSSITER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TOWNSEND CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9118
Mailing Address - Country:US
Mailing Address - Phone:609-744-0136
Mailing Address - Fax:
Practice Address - Street 1:2 TOWNSEND CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9118
Practice Address - Country:US
Practice Address - Phone:609-744-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist