Provider Demographics
NPI:1679518740
Name:CALKINS, KEVIN HOLDEN (MPT)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:HOLDEN
Last Name:CALKINS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 VIRGIE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4136
Mailing Address - Country:US
Mailing Address - Phone:919-416-1373
Mailing Address - Fax:
Practice Address - Street 1:2309 SPARGER RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2227
Practice Address - Country:US
Practice Address - Phone:919-382-0082
Practice Address - Fax:919-383-9112
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC90952251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic