Provider Demographics
NPI:1417957747
Name:SLIWINSKI, KEVIN ANTHONY (PT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:ANTHONY
Last Name:SLIWINSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 PRESIDENT PL
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6807
Mailing Address - Country:US
Mailing Address - Phone:615-220-0086
Mailing Address - Fax:615-220-1682
Practice Address - Street 1:741 PRESIDENT PL
Practice Address - Street 2:SUITE 130
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6807
Practice Address - Country:US
Practice Address - Phone:615-220-0086
Practice Address - Fax:615-220-1682
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist