Healthcare Provider Details

I. General information

NPI: 1578426037
Provider Name (Legal Business Name): KENDRICK BRUCE POMPEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 LINQUIST RD, FORT STEWART, GA
APO AA
31314
US

IV. Provider business mailing address

412 LINQUIST RD, FORT STEWART, GA
APO AA
31314
US

V. Phone/Fax

Practice location:
  • Phone: 717-992-5140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: