NPI 1619032497

Michael P Kavanagh, CPO

Practitioner Orthotist Fort Moore, GA

Practice location

Address: 6600 van Aalst Blvd, Fort Moore, GA 31905-2102
Phone: (762) 408-1467
Mailing address: 125 Perrys Mill Rd, Pine Mountain, GA 31822-5112

Registered specialties (2)

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence 34 (GA)

Other Orthotist providers in Georgia →

Prosthetist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence 34 (GA)

Other Prosthetist providers in Georgia →

Registry record

NPI: 1619032497
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Dec 2006
Record last updated: 4 Feb 2025

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.