Individual
MR. KEVIN WOODSON PERRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
900 WILDFLOWER CIR STE 903, WASHINGTON, PA 15301-9782
(724) 416-7172
(724) 416-3037
Mailing address
900 WILDFLOWER CIR, STE 903, WASHINGTON, PA 15301-9782
(724) 416-3037
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
002197
PA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
10071
OH
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
20117
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002987
WV STATE LICENSE
WV
01
—
020117
PA STATE LICENSE
PA
Enumeration date
06/18/2007
Last updated
10/05/2021
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