Individual
KEVIN J. BOURLAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5882
OR
225100000X
Physical Therapist
PT-1393
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F0051570
HMSA BILLING NUMBER
HI
05
—
24488102
—
HI
05
—
500645456
—
OR
Enumeration date
06/07/2006
Last updated
02/01/2016
Update your record
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