Provider Demographics
NPI:1164903860
Name:WILBUR KAMIEN, KINA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KINA
Middle Name:
Last Name:WILBUR KAMIEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 NETHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1234
Mailing Address - Country:US
Mailing Address - Phone:603-560-3430
Mailing Address - Fax:
Practice Address - Street 1:70 BUTLER ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3925
Practice Address - Country:US
Practice Address - Phone:603-560-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist