Doctor Name: | DR. KENNETH WORLANYO WUTOH |
NPI Number: | 1427454065 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT, CKPI |
License Number: | 9016 |
Business Practice Address: | 520 Rose Ln Wickenburg, AZ - 853901447 |
Business Phone Number: | 9286843604 |
Business Fax Number: | |
Mailing Address: | 12023 W Windrose Dr, EL MIRAGE |
State: | AZ |
Postal Code: | 853354323 |
Phone Number: | 7015704006 |
Fax Number: | |
NPI Enumeration Date: | 11/10/2014 |
NPI Last Update Date: | 11/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 9016 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |