Provider Demographics
NPI:1346546835
Name:SALDANHA, KEVIN GLEN (PT; DPT)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:GLEN
Last Name:SALDANHA
Suffix:
Gender:M
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 1:7501 LEAD MINE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4825
Mailing Address - Country:US
Mailing Address - Phone:919-424-5080
Mailing Address - Fax:919-424-5085
Practice Address - Street 1:7501 LEAD MINE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4825
Practice Address - Country:US
Practice Address - Phone:919-424-5080
Practice Address - Fax:919-424-5085
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13018172M00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP13018OtherNC PHYSICAL THERAPY LICENSE NUMBER