NPI 1003315151

Thomas Charles Kinne

Practitioner Respite Care Fredonia, AZ

Practice location

Address: 314 Aspen Street, Fredonia, AZ 86022
Phone: (928) 925-5992
Mailing address: PO Box 491, Fredonia, AZ 86022-0491

Registered specialties

Respite Care Primary

Respite Care Facility Taxonomy 385H00000X Licence 8876774 (AZ)

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Registry record

NPI: 1003315151
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Feb 2018
Record last updated: 5 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.