Provider Demographics
NPI:1386055390
Name:STRUNK, KYLE STEVEN (MS, ATC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:STEVEN
Last Name:STRUNK
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 KRUGER PL
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-9154
Mailing Address - Country:US
Mailing Address - Phone:228-257-1428
Mailing Address - Fax:
Practice Address - Street 1:7009 KRUGER PL
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-9154
Practice Address - Country:US
Practice Address - Phone:228-257-1428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer