Provider Demographics
NPI:1891880894
Name:BIGLEY, KEVIN ANDREW (MSPT)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:ANDREW
Last Name:BIGLEY
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4375
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-4375
Mailing Address - Country:US
Mailing Address - Phone:775-885-9965
Mailing Address - Fax:775-885-9969
Practice Address - Street 1:4560 S CARSON ST STE 2
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-6915
Practice Address - Country:US
Practice Address - Phone:775-885-9965
Practice Address - Fax:775-885-9969
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0844225100000X
NV0844225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003403002Medicaid
NVNV9269OtherBCBS