Provider Demographics
NPI:1740764984
Name:CATTIE, KEVIN JR (DC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:CATTIE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1701
Mailing Address - Country:US
Mailing Address - Phone:610-361-0070
Mailing Address - Fax:610-361-0071
Practice Address - Street 1:3039 FOULK RD
Practice Address - Street 2:
Practice Address - City:GARNET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19060-1701
Practice Address - Country:US
Practice Address - Phone:610-361-0070
Practice Address - Fax:610-361-0071
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor