| Doctor Name: | KEVIN WILLENBRING |
| NPI Number: | 1265789143 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT010676 |
| Business Practice Address: | 105 Moores Grove Rd Winterville, GA - 306831517 |
| Business Phone Number: | 7067420082 |
| Business Fax Number: | 7067420083 |
| Mailing Address: | 500 Market St, Suite 103 BEAVER |
| State: | PA |
| Postal Code: | 150092998 |
| Phone Number: | 7247287550 |
| Fax Number: | 7247286648 |
| NPI Enumeration Date: | 08/09/2012 |
| NPI Last Update Date: | 02/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT010676 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |