Provider Demographics
NPI:1568737039
Name:DAVID, KEVIN GREGORY (DPT)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:GREGORY
Last Name:DAVID
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:203 VERMILLION DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15209-2157
Mailing Address - Country:US
Mailing Address - Phone:503-453-2900
Mailing Address - Fax:
Practice Address - Street 1:321 PENNWOOD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3308
Practice Address - Country:US
Practice Address - Phone:503-453-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385212251X0800X
PAPT0240082251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic