Individual
KIRK D KINGERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1055 N 500 W, SUITE 122, PROVO, UT 84604-3305
(801) 429-0610
(801) 429-0629
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 429-8150
Taxonomy
Speciality
Code
Description
License number
State
2251H1200X
Hand Physical Therapist
Primary
260693-2401
UT
Other
Enumeration date
08/31/2006
Last updated
04/11/2008
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