Kevin Blaine Bingham, PTA

NPI #1679078331 in Sublimity, Oregon

Provider Information

NPI Number: 1679078331
Entity Type: Individual
Name: Kevin Blaine Bingham, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Mar 26, 2018
Last Updated: Mar 26, 2018

Practice Location

Address: 390 SE CHURCH ST
City: Sublimity
State: Oregon
ZIP Code: 97385-9714
Phone: (801) 550-5329

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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