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General NPI Number Information
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NPI Number | 1225151467
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Entity Type | Individual
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Provider Name | KEVIN ROBERT THORPE D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 1475 PALM COAST PKWY NW SUITE103
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City | PALM COAST
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State | FL
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Zip | 32137-4735
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Country | US
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Telephone | 386-986-1823
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Fax | 386-986-1924
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Provider Business Mailing Address
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Address Line | 1475 PALM COAST PKWY NW SUITE103
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City | PALM COAST
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State | FL
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Zip | 32137-4735
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Country | US
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Telephone | 386-986-1823
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Fax | 386-986-1924
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9340
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License Number State | FL
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