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General NPI Number Information
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NPI Number | 1548780752
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Entity Type | Individual
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Provider Name | JUSTIN M KILGORE DPT
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Gender | Male
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | MEDDAC-BAVARIA CMR 411
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City | APO
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State | AE
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Zip | 09112
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Country | US
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Telephone | 314-390-4324
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Fax |
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Provider Business Mailing Address
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Address Line | U.S. ARMY HEALTH CLINIC GRAFENWOEHR UNIT 28130
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City | APO
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State | AE
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Zip | 09114
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Country | US
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Telephone |
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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 | 295051
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License Number State | CA
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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 | PTL.0017974
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11306
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License Number State | TN
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