Provider Demographics
NPI:1205257896
Name:MCGINNIS, KAITLIN DAWN (ATC)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:DAWN
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ROCK RDG
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19543-9533
Mailing Address - Country:US
Mailing Address - Phone:484-364-9502
Mailing Address - Fax:
Practice Address - Street 1:20 ROCK RDG
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:PA
Practice Address - Zip Code:19543-9533
Practice Address - Country:US
Practice Address - Phone:484-364-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer