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General NPI Number Information
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NPI Number | 1174384648
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Entity Type | Individual
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Provider Name | KENNETH MCGIRR
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Gender | Male
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 765 N DETROIT ST
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City | XENIA
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State | OH
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Zip | 45385-1960
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Country | US
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Telephone | 937-505-1877
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | 371 XENIA AVE APT 1
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City | DAYTON
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State | OH
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Zip | 45410-1536
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Country | US
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Telephone | 937-407-5144
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | APS.006269
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License Number State | OH
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