Provider Demographics
NPI:1841984762
Name:HENSLEY, KYLER DEAN
Entity type:Individual
Prefix:MR
First Name:KYLER
Middle Name:DEAN
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 NW 39TH EXPY FL CENTER3
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2868
Mailing Address - Country:US
Mailing Address - Phone:405-981-4001
Mailing Address - Fax:
Practice Address - Street 1:6401 NW 39TH EXPY FL CENTER3
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2868
Practice Address - Country:US
Practice Address - Phone:405-981-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant