Healthcare Provider Details

I. General information

NPI: 1376976977
Provider Name (Legal Business Name): KEVIN MICHAEL PIPHER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CONKEY AVE UHS THERAPIES NORWICH
NORWICH NY
13815-1756
US

IV. Provider business mailing address

26 CONKEY AVE BOX 136
NORWICH NY
13815-1756
US

V. Phone/Fax

Practice location:
  • Phone: 607-334-5010
  • Fax: 607-336-7326
Mailing address:
  • Phone: 607-334-5010
  • Fax: 607-336-7326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number036565
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: