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Individual

KEVIN LEE HINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8338 HIGHWAY 65 NE STE E, SPRING LAKE PARK, MN 55432-1365
(763) 755-9500
(763) 755-9510
Mailing address
8338 HIGHWAY 65 NE STE E, SPRING LAKE PARK, MN 55432-1365
(763) 755-9500
(763) 755-9510

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1001
MN

Other

Enumeration date
06/14/2022
Last updated
06/14/2022
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