Individual
LINCOLN NATHANIEL KINKADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001573
WV BOARD OF PT
WV
01
—
001708627
BC BS
—
05
—
0157306000
—
WV
01
—
9335681
GROUP
WV
01
—
9335682
GROUP
WV
01
—
9335683
GROUP
WV
01
—
9335684
GROUP
WV
Enumeration date
09/02/2005
Last updated
08/03/2023
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