Individual
KEVIN ANDREW PHYSIOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
760 S AUBURN ST STE C2, GRASS VALLEY, CA 95945-4318
(530) 265-5811
Mailing address
334 MILL ST APT D, GRASS VALLEY, CA 95945-6727
(530) 460-7656
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
07/24/2025
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