Provider Demographics
NPI:1568961266
Name:HARTMAN, KEVIN JAMES (CP BOCO)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JAMES
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:CP BOCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3499 S LINDEN RD STE 6
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3022
Mailing Address - Country:US
Mailing Address - Phone:810-265-7488
Mailing Address - Fax:
Practice Address - Street 1:3499 S LINDEN RD STE 6
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3022
Practice Address - Country:US
Practice Address - Phone:810-265-7488
Practice Address - Fax:810-265-7689
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist