Provider Demographics
NPI:1073303871
Name:AIKIN-FISK, KINLEY LINDELL (PTA)
Entity type:Individual
Prefix:
First Name:KINLEY
Middle Name:LINDELL
Last Name:AIKIN-FISK
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:KINLEY
Other - Middle Name:LINDELL
Other - Last Name:AIKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1821 N WELLS ST
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-3343
Mailing Address - Country:US
Mailing Address - Phone:806-663-2634
Mailing Address - Fax:806-641-1799
Practice Address - Street 1:901 S SWEETWATER ST # 1030
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:TX
Practice Address - Zip Code:79096-2428
Practice Address - Country:US
Practice Address - Phone:806-425-1850
Practice Address - Fax:806-425-1850
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21516032081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine