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Individual
KIRK W NEWBOLD
Active
Individual
KIRK W NEWBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4809421-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137576-005
CIGNA
UT
01
—
48094212401001
BCBS TRADITIONAL
UT
01
—
6400700
UNITED HEALTHCARE
UT
01
—
77716
PEHP
UT
Enumeration date
09/26/2005
Last updated
08/22/2007
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