Provider Demographics
NPI:1851557938
Name:T0, KEVIN C (MT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:C
Last Name:T0
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BILLINGS RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2353
Mailing Address - Country:US
Mailing Address - Phone:617-472-8807
Mailing Address - Fax:617-472-3986
Practice Address - Street 1:38 BILLINGS RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2353
Practice Address - Country:US
Practice Address - Phone:617-472-8807
Practice Address - Fax:617-472-3986
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA369174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist