Provider Demographics
NPI:1760503544
Name:BIGGERSTAFF, B. KENT (ATC)
Entity Type:Individual
Prefix:
First Name:B.
Middle Name:KENT
Last Name:BIGGERSTAFF
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 W GROVE PL
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6067
Mailing Address - Country:US
Mailing Address - Phone:724-935-1445
Mailing Address - Fax:
Practice Address - Street 1:3007 W GROVE PL
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-6067
Practice Address - Country:US
Practice Address - Phone:724-935-1445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001434A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer