Provider Demographics
NPI:1508299850
Name:DIGIULIO, KEVIN M (DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:DIGIULIO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7508 LORETTO AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3833
Mailing Address - Country:US
Mailing Address - Phone:267-408-0398
Mailing Address - Fax:
Practice Address - Street 1:7508 LORETTO AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-3833
Practice Address - Country:US
Practice Address - Phone:267-399-3789
Practice Address - Fax:267-388-9110
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-022980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist