Provider Demographics
NPI:1720888167
Name:URBIN, JOSEPH KAPIGENO
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KAPIGENO
Last Name:URBIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10726 LONNIE LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGE DALE
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8522
Mailing Address - Country:US
Mailing Address - Phone:509-655-5417
Mailing Address - Fax:
Practice Address - Street 1:9408 APISON PIKE STE 174
Practice Address - Street 2:
Practice Address - City:COLLEGE DALE
Practice Address - State:TN
Practice Address - Zip Code:37363-5977
Practice Address - Country:US
Practice Address - Phone:423-702-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12413117042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer