Basic Information
Provider Information
NPI: 1396412862
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANK-DELANEY
FirstName: KYLIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 475 ALLENDALE RD STE 206
Address2:  
City: KING OF PRUSSIA
State: PA
PostalCode: 194061495
CountryCode: US
TelephoneNumber: 6102700370
FaxNumber:  
Practice Location
Address1: 686 DEKALB PIKE STE 101
Address2:  
City: BLUE BELL
State: PA
PostalCode: 194221258
CountryCode: US
TelephoneNumber: 6102700300
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/24/2021
LastUpdateDate: 08/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800XPT029856PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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