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General NPI Number Information
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NPI Number | 1154862985
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Entity Type | Individual
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Provider Name | KEVIN VIKEN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 6400 MECHANICSVILLE TPKE
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4579
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Country | US
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Telephone | 804-789-8829
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 MECHANICSVILLE TPKE STE A
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4579
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Country | US
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Telephone | 804-789-8290
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2072
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210535
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License Number State | VA
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