Individual
KEVIN A PASSERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-3908
Mailing address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-3908
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001135
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156572000
—
WV
05
—
2701802
—
OH
Enumeration date
08/14/2006
Last updated
08/14/2024
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