Provider Demographics
NPI:1841392495
Name:CALL, KEVIN SPENCER (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:SPENCER
Last Name:CALL
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-9327
Mailing Address - Country:US
Mailing Address - Phone:908-475-5189
Mailing Address - Fax:
Practice Address - Street 1:41 JACKSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1017
Practice Address - Country:US
Practice Address - Phone:908-689-3050
Practice Address - Fax:908-689-4900
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT00076500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist