Provider Demographics
NPI:1992676894
Name:KMKAZ & CO, LLC
Entity type:Organization
Organization Name:KMKAZ & CO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONOR
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:828-551-4400
Mailing Address - Street 1:524 ABERDEEN DR APT 202
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4016
Mailing Address - Country:US
Mailing Address - Phone:828-551-4400
Mailing Address - Fax:
Practice Address - Street 1:50051 GOVERNORS DR STE E
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7018
Practice Address - Country:US
Practice Address - Phone:984-999-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy