Kevin Addison, ATC
Specialist/Technologist, Athletic Trainer in Philadelphia, PA. Individual provider (NPI-1).
NPI number1649029364
StatusActive
Last updated in NPPESMay 15, 2024
Details
- NPI
- 1649029364
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kevin Addison
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 15, 2024
- Certification date
- May 15, 2024
- Last updated
- May 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
1800 N Broad StPhiladelphia, PA 19121-3302
Phone 215-204-7444
Mailing address
14 Argyle AveBlackwood, NJ 08012-4561
Phone 803-467-9652
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