Individual
MR. PAUL RAY KINNEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT FAAO MPT
Contact information
Practice address
115 NATOMA ST, FOLSOM, CA 95630-2615
(916) 355-8500
(916) 355-8196
Mailing address
115 NATOMA ST, FOLSOM, CA 95630-2615
(916) 355-8500
(916) 355-8196
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT22365
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT223650
BLUE SHIELD
CA
01
—
PT22365
BLUE CROSS OF CA PT LIC #
—
Enumeration date
11/15/2006
Last updated
12/30/2021
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