Individual
MR. BENTON CLAY KINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2865 CHURN CREEK RD, SUITE A, REDDING, CA 96002-1117
(530) 646-7269
(530) 275-2201
Mailing address
1999 SALZBURG TRL, REDDING, CA 96003-9334
(530) 209-5978
(530) 275-2201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16208
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006799550
—
CA
Enumeration date
05/21/2007
Last updated
11/26/2014
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