Individual
MR. KEVIN WAYNE WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1443 IRISBURG RD, AXTON, VA 24054-2388
(276) 732-1658
Mailing address
1443 IRISBURG RD, AXTON, VA 24054-2388
(276) 732-1658
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306601918
VA
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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