Provider Demographics
NPI:1083909352
Name:PLAYER, KIRK R (DPT)
Entity Type:Individual
Prefix:MR
First Name:KIRK
Middle Name:R
Last Name:PLAYER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008-0027
Mailing Address - Country:US
Mailing Address - Phone:775-726-3117
Mailing Address - Fax:775-726-3118
Practice Address - Street 1:820 N. SPRING ST
Practice Address - Street 2:SUITE C
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008
Practice Address - Country:US
Practice Address - Phone:775-726-3117
Practice Address - Fax:775-726-3118
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2555225100000X
UT7946637-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVFG721ZMedicare PIN