Provider Demographics
NPI:1730832403
Name:COMBS, KENT PATRICK
Entity type:Individual
Prefix:MR
First Name:KENT
Middle Name:PATRICK
Last Name:COMBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 S ALMA SCHOOL RD STE B104
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3040
Mailing Address - Country:US
Mailing Address - Phone:480-993-2178
Mailing Address - Fax:
Practice Address - Street 1:1930 S ALMA SCHOOL RD STE B104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3040
Practice Address - Country:US
Practice Address - Phone:480-993-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner