| Organization Name: | KORNERSTONE KIDS PS |
| NPI Number: | 1023478641 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREG PENNER (FOUNDER) |
| Mailing Address: | 400 Sequoia Dr Suite 120 Bellingham |
| State: | WA US |
| Postal Code: | 982267133 |
| Phone Number: | 3603541115 |
| Fax Number: | |
| NPI Enumeration Date: | 02/24/2016 |
| NPI Last Update Date: | 03/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |