1033271721 NPI number — HELEN R, KINZER, MPT, LLC

Table of content: (NPI 1033271721)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033271721 NPI number — HELEN R, KINZER, MPT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELEN R, KINZER, MPT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033271721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1056
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULPEPER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22701-1056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-229-2357
Provider Business Mailing Address Fax Number:
540-825-7761

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 W PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULPEPER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22701-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-229-2357
Provider Business Practice Location Address Fax Number:
540-825-7761
Provider Enumeration Date:
12/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KINZER
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
OWNER MEMBER
Authorized Official Telephone Number:
540-229-2357

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  2305005805 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)