Provider Demographics
NPI:1598849689
Name:MCLAUGHLIN, KEVIN M (PT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 CHATEAU CT
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2103
Mailing Address - Country:US
Mailing Address - Phone:410-638-0700
Mailing Address - Fax:
Practice Address - Street 1:3718B NORRISVILLE RD
Practice Address - Street 2:
Practice Address - City:JARRETTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21084-1419
Practice Address - Country:US
Practice Address - Phone:410-692-9180
Practice Address - Fax:410-692-9750
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist