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General NPI Number Information
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NPI Number | 1942841853
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Entity Type | Individual
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Provider Name | KINSLEY FITZPATRICK DPT
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Gender | Female
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 2814 S BALTIMORE ST
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City | KIRKSVILLE
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State | MO
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Zip | 63501-4640
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Country | US
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Telephone | 660-785-1832
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 S MARION ST APT G
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City | KIRKSVILLE
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State | MO
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Zip | 63501-4745
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Country | US
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Telephone | 314-605-4208
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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 | 2019026524
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License Number State | MO
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