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General NPI Number Information
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NPI Number | 1568343556
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Entity Type | Individual
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Provider Name | KEVIN CONWAY DPT
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Gender | Male
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1375 BLOSSOM HILL RD STE 33
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City | SAN JOSE
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State | CA
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Zip | 95118-3825
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Country | US
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Telephone | 408-784-7167
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Fax |
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Provider Business Mailing Address
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Address Line | 845 HILLCREST DR
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City | REDWOOD CITY
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State | CA
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Zip | 94062-3037
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Country | US
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Telephone | 401-787-6250
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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 | 304151
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License Number State | CA
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