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NPI Code Detail

MEDICARE: MR. STEPHEN JOHN KERR PT

MEDICARE:  MR. STEPHEN JOHN KERR  PT
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
12251G0304XGeriatric Physical Therapist3264NM

General Provider Information

NPI Number : 1386965671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN JOHN KERR PT
Provider Business Mailing Address
First Line : 3941 DESERT WILLOW DR NE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87144-2627
Country : US
Telephone Number : 505-990-4428
Fax Number :
Provider Business Practice Location Address
First Line : 103 HOSPITAL LOOP NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-2115
Country : US
Telephone Number : 505-348-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 06/21/2010

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Directions to “ MR. STEPHEN JOHN KERR PT” Practice Location

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