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NPI Code Detail

MEDICARE: CASSIDY KIRVEN

MEDICARE: CASSIDY KIRVEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist019371OH

General Provider Information

NPI Number : 1194392050
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIDY KIRVEN
Provider Business Mailing Address
First Line : 926 WISE AVE SE
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-3766
Country : US
Telephone Number : 307-041-8003
Fax Number :
Provider Business Practice Location Address
First Line : 17 E RIVER ST STE A
Second Line :
City : NEWTON FALLS
State : OH
Zip : 44444-1372
Country : US
Telephone Number : 330-872-7242
Fax Number : 330-872-7372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2021
Last Update Date : 06/09/2021

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Directions to “ CASSIDY KIRVEN ” Practice Location

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