Provider Demographics
NPI:1700323201
Name:ZEVAN LUNBERY, KIRA MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:MARIE
Last Name:ZEVAN LUNBERY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KIRA
Other - Middle Name:MARIE
Other - Last Name:ZEVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 NW NORTHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-1628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8715 VILLAGE DR STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5425
Practice Address - Country:US
Practice Address - Phone:210-477-5151
Practice Address - Fax:210-477-5152
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX12895302251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist