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NPI Code Detail

MEDICARE: KENNETH WAYNE SPRINGER

MEDICARE: KENNETH WAYNE SPRINGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1869TN

General Provider Information

NPI Number : 1750572210
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH WAYNE SPRINGER
Provider Business Mailing Address
First Line : PO BOX 300
Second Line :
City : DRESDEN
State : TN
Zip : 38225-0300
Country : US
Telephone Number : 731-364-6060
Fax Number : 731-364-6070
Provider Business Practice Location Address
First Line : 130 E LOCUST ST
Second Line :
City : DRESDEN
State : TN
Zip : 38225-1467
Country : US
Telephone Number : 731-364-6060
Fax Number : 731-364-6070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2007
Last Update Date : 12/06/2013

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Directions to “ KENNETH WAYNE SPRINGER ” Practice Location

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