Healthcare Provider Details

I. General information

NPI: 1073303871
Provider Name (Legal Business Name): KINLEY LINDELL AIKIN-FISK PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KINLEY LINDELL AIKIN PTA

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S SWEETWATER ST # 1030
WHEELER TX
79096-2428
US

IV. Provider business mailing address

1821 N WELLS ST
PAMPA TX
79065-3343
US

V. Phone/Fax

Practice location:
  • Phone: 806-425-1850
  • Fax: 806-425-1850
Mailing address:
  • Phone: 806-663-2634
  • Fax: 806-641-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number2151603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: