Provider Demographics
NPI:1174384648
Name:MCGIRR, KENNETH LEE II
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:LEE
Last Name:MCGIRR
Suffix:II
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 1:1156 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-3608
Mailing Address - Country:US
Mailing Address - Phone:937-408-2560
Mailing Address - Fax:
Practice Address - Street 1:1156 BEECH ST
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-3608
Practice Address - Country:US
Practice Address - Phone:937-408-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care