Individual
KEVIN MICHAEL HUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PTA
Contact information
Practice address
763 LAKEFAIR PL N, KEIZER, OR 97303-3585
(360) 961-7754
Mailing address
763 LAKEFAIR PL N, KEIZER, OR 97303-3585
(360) 961-7754
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8554
OR
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
10/05/2005
Last updated
10/07/2009
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