| Organization Name: | KENTWOOD PHYSICAL THERAPY, PLLC |
| NPI Number: | 1134331689 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ADAM B BEADENKOPF (CO-OWNER) |
| Mailing Address: | 1423 60th St Se Kentwood |
| State: | MI US |
| Postal Code: | 495087065 |
| Phone Number: | 6164469058 |
| Fax Number: | 6168216162 |
| NPI Enumeration Date: | 05/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501010446 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |