Provider Demographics
NPI:1649018474
Name:KINGSTON, NAVIN (PT)
Entity type:Individual
Prefix:
First Name:NAVIN
Middle Name:
Last Name:KINGSTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 NEEDLELEAF DR
Mailing Address - Street 2:
Mailing Address - City:WINNABOW
Mailing Address - State:NC
Mailing Address - Zip Code:28479-5841
Mailing Address - Country:US
Mailing Address - Phone:910-721-8652
Mailing Address - Fax:
Practice Address - Street 1:1169 NEEDLELEAF DR
Practice Address - Street 2:
Practice Address - City:WINNABOW
Practice Address - State:NC
Practice Address - Zip Code:28479-5841
Practice Address - Country:US
Practice Address - Phone:910-721-8652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist