Provider Demographics
NPI:1528833480
Name:STRONG, KEVIN A (DC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:A
Last Name:STRONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 IVORY RD
Mailing Address - Street 2:
Mailing Address - City:FREWSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14738-9591
Mailing Address - Country:US
Mailing Address - Phone:716-969-4852
Mailing Address - Fax:
Practice Address - Street 1:25 HARRISON ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-6653
Practice Address - Country:US
Practice Address - Phone:716-969-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program