Doctor Name: | MR. KENNETH MARK WILNER |
NPI Number: | 1467775155 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 19059 |
Business Practice Address: | 1016 Continentals Way Apt 201 Belmont, CA - 940023161 |
Business Phone Number: | 6505913073 |
Business Fax Number: | 6505913073 |
Mailing Address: | 1016 Continentals Way, Apt 201 BELMONT |
State: | CA |
Postal Code: | 940023161 |
Phone Number: | 6505913073 |
Fax Number: | 6505913073 |
NPI Enumeration Date: | 03/09/2010 |
NPI Last Update Date: | 03/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 19059 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |