Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 5501019794 | MI |
N | 2251X0800X | Physical Therapist - Orthopedic | 5501019794 | MI |
NPI | 1487254561 |
---|---|
Provider Name | Dr. Eric Kinney |
First Address | Howell, MI 48843-7900 |
Second Address | Novi, MI 48374-1319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2020 |
Last Update Date | 28/10/2020 |