Provider Demographics
NPI:1316613029
Name:DAVIES, KEVIN CURTIS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CURTIS
Last Name:DAVIES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 S PROVIDENCE RD APT B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3541
Mailing Address - Country:US
Mailing Address - Phone:903-816-1584
Mailing Address - Fax:
Practice Address - Street 1:1600 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-2478
Practice Address - Country:US
Practice Address - Phone:660-263-6887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021031367225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist