KEVIN BLAINE BINGHAM PTA
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1679078331- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA
- Status
- Active
Contact & Location
- Address
- 390 SE CHURCH ST, SUBLIMITY, OR, 973859714
- Phone
- (801) 550-5329
Specialties & Taxonomies
Physical Therapy Assistant
License: UT #8177960-2402
Physical Therapy Assistant
Primary License: OR #09469