Granger, Kevin Joseph

Granger, Kevin Joseph is an individual health care provider with primary practice located at 4308 Carlisle Blvd, Ne Suite 209, Albuquerque NM 87107. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Granger, Kevin Joseph can be contacted via phone (505) 828-0232.

Contact Information

Primary practice address
4308 Carlisle Blvd, Ne Suite 209 Albuquerque NM 87107
Phone: (505) 828-0232
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X A-160 New Mexico

Profile Details

NPI number 1023148863
LBN Legal business name Granger, Kevin Joseph
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023148863 NPPES
New Mexico Other A-160 PHYSICAL THERAPIST ASST

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