Provider Demographics
NPI:1871895896
Name:FRACTION, KEVIN
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:FRACTION
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 1:8025 W RUSSELL RD
Mailing Address - Street 2:ST #2106
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1579
Mailing Address - Country:US
Mailing Address - Phone:414-702-9721
Mailing Address - Fax:
Practice Address - Street 1:8025 W RUSSELL RD
Practice Address - Street 2:ST #2106
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1579
Practice Address - Country:US
Practice Address - Phone:414-702-9721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner