Provider Demographics
NPI:1073342341
Name:KIRCHMAN, PHILIP (LAT, ATC)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:KIRCHMAN
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6857 MARBLE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3612
Mailing Address - Country:US
Mailing Address - Phone:775-857-7141
Mailing Address - Fax:
Practice Address - Street 1:4714 GETTYSBURG RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4325
Practice Address - Country:US
Practice Address - Phone:888-735-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAT05067842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer