Individual
KEVIN M. HESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4020 RAINTREE RD, SUITE D, CHESAPEAKE, VA 23321-3749
(757) 484-4241
(757) 484-4487
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-0930
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
017353-1
NY
225100000X
Physical Therapist
Primary
2305210751
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104819812
—
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
01
—
Q56530A
MEDICARE PTAN
—
Enumeration date
08/27/2005
Last updated
04/16/2018
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