Provider Demographics
NPI:1649568676
Name:K-2 HEALTHCARE CONSULTING
Entity Type:Organization
Organization Name:K-2 HEALTHCARE CONSULTING
Other - Org Name:K2 SPORTS THERAPY AND PERFORMANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCKO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:704-360-2595
Mailing Address - Street 1:PO BOX 3534
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117
Mailing Address - Country:US
Mailing Address - Phone:704-360-2595
Mailing Address - Fax:704-360-2596
Practice Address - Street 1:508 WILLIAMSON ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117
Practice Address - Country:US
Practice Address - Phone:704-360-2595
Practice Address - Fax:704-360-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC-6830261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy