Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 225000000X | Orthotic Fitter |
NPI | 1225275753 |
---|---|
Provider Name | Mr. Kavin K Mcgee |
First Address | Stockbridge, GA 30281-4351 |
Second Address | Stockbridge, GA 30281-4351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2009 |
Last Update Date | 21/01/2009 |