Provider Demographics
NPI:1962545301
Name:KINSEY, WILLIAM ANTHONY (ATC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:KINSEY
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 1:532 SW A ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-4023
Mailing Address - Country:US
Mailing Address - Phone:765-939-6306
Mailing Address - Fax:
Practice Address - Street 1:801 NATIONAL RD W
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-4021
Practice Address - Country:US
Practice Address - Phone:765-983-1312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000466A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer