Individual
DR. KEVIN KIRK ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
224 W D. L. INGRAM AVE, BLDG. 1408, CLOVIS, NM 88103
(770) 714-8214
Mailing address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CLOVIS, NM 88103
(575) 904-3934
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013999
GA
261QP2000X
Physical Therapy Clinic/Center
PT013999
GA
Other
Enumeration date
06/14/2019
Last updated
03/13/2024
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