Doctor Name: | DYLAN KENT |
NPI Number: | 1376919548 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT-4222 |
Business Practice Address: | 645 E State St Ste 101 Eagle, ID - 836165914 |
Business Phone Number: | 2089399594 |
Business Fax Number: | 2089399594 |
Mailing Address: | 645 E State St, Ste 101 EAGLE |
State: | ID |
Postal Code: | 836165914 |
Phone Number: | 2089399594 |
Fax Number: | 2089399594 |
NPI Enumeration Date: | 08/11/2015 |
NPI Last Update Date: | 08/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-4222 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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 |