Provider Demographics
NPI:1477837292
Name:TEMPLIN, KEVIN TERRY (OPA-C, ATC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:TERRY
Last Name:TEMPLIN
Suffix:
Gender:M
Credentials:OPA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:14825 N OUTER 40 RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2152
Mailing Address - Country:US
Mailing Address - Phone:314-336-2555
Mailing Address - Fax:314-336-2655
Practice Address - Street 1:14825 N OUTER 40 RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2152
Practice Address - Country:US
Practice Address - Phone:314-336-2555
Practice Address - Fax:314-336-2655
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant