Provider Demographics
NPI:1427437300
Name:KITCHEN, ADDAM (ATC)
Entity type:Individual
Prefix:
First Name:ADDAM
Middle Name:
Last Name:KITCHEN
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 1:3443 PARK ST APT 321
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-0015
Mailing Address - Country:US
Mailing Address - Phone:440-752-2937
Mailing Address - Fax:
Practice Address - Street 1:4500 BIG RUN SOUTH RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9687
Practice Address - Country:US
Practice Address - Phone:614-801-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer