Provider Demographics
NPI:1336728690
Name:DUNCAN, KERRY JOHN JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:KERRY
Middle Name:JOHN
Last Name:DUNCAN
Suffix:JR
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 1:9000 E NICHOLS AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3429
Mailing Address - Country:US
Mailing Address - Phone:844-274-6849
Mailing Address - Fax:
Practice Address - Street 1:6380 DENTON WAY APT 38
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-5157
Practice Address - Country:US
Practice Address - Phone:916-837-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0608024412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer