| Doctor Name: | KENNETTE R. WYNN |
| NPI Number: | 1407049430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 2006001837 |
| Business Practice Address: | 10300 W 103rd St Suite 300 Overland Park, KS - 662142642 |
| Business Phone Number: | 9138941910 |
| Business Fax Number: | |
| Mailing Address: | 15202 Grand Summit Blvd Apt 204, GRANDVIEW |
| State: | MO |
| Postal Code: | 640302790 |
| Phone Number: | 4173997339 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2007 |
| NPI Last Update Date: | 08/22/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2006001837 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| 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 |