Provider Demographics
NPI:1699443275
Name:KOVACH, KYLE MICHAEL II (DPT)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:MICHAEL
Last Name:KOVACH
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:KOVACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6050 TACOMA MALL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6828
Mailing Address - Country:US
Mailing Address - Phone:253-581-5200
Mailing Address - Fax:
Practice Address - Street 1:10141 224TH ST E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-9190
Practice Address - Country:US
Practice Address - Phone:253-446-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist