Individual
KENNETH ROBERT KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T, N.D.
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
Mailing address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
000417
CT
225100000X
Physical Therapist
Primary
005244
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080005244CT24
ANTHEM
CT
Enumeration date
10/24/2007
Last updated
02/10/2012
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