Provider Demographics
NPI:1457542052
Name:AUFFREY, KEVIN MATTHEW (ATC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MATTHEW
Last Name:AUFFREY
Suffix:
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 1:92 PONDVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9153
Mailing Address - Country:US
Mailing Address - Phone:413-323-8162
Mailing Address - Fax:
Practice Address - Street 1:1111 ELM ST
Practice Address - Street 2:SUITE 33
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-781-7538
Practice Address - Fax:413-781-0982
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer