Provider Demographics
NPI:1174628002
Name:TURPEL, KEVIN MATTHEW (ATC/ LAT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MATTHEW
Last Name:TURPEL
Suffix:
Gender:M
Credentials:ATC/ LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MAPLE AVE S APT 1
Mailing Address - Street 2:
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9582
Mailing Address - Country:US
Mailing Address - Phone:262-305-3669
Mailing Address - Fax:262-644-7860
Practice Address - Street 1:1048 E COMMERCE BLVD
Practice Address - Street 2:
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9326
Practice Address - Country:US
Practice Address - Phone:262-644-6268
Practice Address - Fax:262-644-7860
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer