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General NPI Number Information
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NPI Number | 1447310099
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Entity Type | Organization
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Legal Business Name | KINETIC HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1125 WEST STREET SUITE 304
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City | ANNAPOLIS
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State | MD
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Zip | 21401-4198
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Country | US
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Telephone | 703-622-9032
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Fax | 800-936-3359
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Provider Business Mailing Address
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Address Line | 1125 WEST STREET SUITE 304
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City | ANNAPOLIS
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State | MD
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Zip | 21401-4198
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Country | US
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Telephone | 703-622-9032
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Fax | 800-936-3359
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIMOTHY JOHN MULVIHILL JR.
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Credential | A.T.,C.
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Telephone | 703-622-9032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT-001446-A
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 02171211
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 02171211
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License Number State | MD
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