Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kiseok Kwon, DPT

Individual provider Physical Therapist · NPI 1508234311

Dr. Kiseok Kwon, DPT is a Physical Therapist in Private Practice in Duluth, Georgia. Qualified in 2015, 11 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Georgia and Maryland.

Years since qualifying
11
Licensed in
GA, MD
In the registry since
2015
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3473 Satellite Blvd
Duluth, GA 30096-8690
Phone: (909) 747-8205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8007 Corporate Dr, Nottingham, MD 21236-4905 — (410) 256-8511

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT013151 (GA)
Physical Therapist Taxonomy 225100000X · Licence 25657 (MD)

Record details

NPI number1508234311
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedSeptember 10, 2015
Last updated in NPPESMarch 17, 2018
Mailing address3355 McDaniel Rd Apt 8306, Duluth, GA 30096-8646

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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