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Individual

DR. KEVIN LEE KILLIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
534 WEST JOHN STREET, MATTHEWS FOOT CARE, MATTHEWS, NC 28105
(704) 847-9788
(704) 849-2928
Mailing address
534 WEST JOHN STREET, M AND L PODIATRY, MATTHEWS, NC 28105
(704) 847-9788
(704) 849-2928

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
312
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
312
STATE LICENSE
NC
05
890806N
NC
Enumeration date
09/19/2005
Last updated
08/31/2010
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