Shaddock, Kevin

Shaddock, Kevin is an sole proprietor health care provider with primary practice located at 816 A1A N Ste 307 , Ponte Vedra FL 32082-3219. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, which is considered as his primary health care specialty. Shaddock, Kevin can be contacted via phone (402) 190-4543.

Contact Information

Primary practice address
816 A1A N Ste 307 Ponte Vedra FL 32082-3219
Phone: (402) 190-4543
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics 2251G0304X PT33637 Florida

Profile Details

NPI number 1568940617
LBN Legal business name Shaddock, Kevin
Credentials DPT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2018
Last updated Jul 31st, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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