Individual
IAN KINCADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(850) 529-8212
Mailing address
6597 SNOW APPLE DR, CLARKSTON, MI 48346-2159
(850) 529-8212
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005582
MI
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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