Healthcare Provider Details

I. General information

NPI: 1164199980
Provider Name (Legal Business Name): KRISTIN KENNEDY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S CLINTON ST STE 300-10
DOYLESTOWN PA
18901-4220
US

IV. Provider business mailing address

17 CAROUSEL CIR
DOYLESTOWN PA
18901-5024
US

V. Phone/Fax

Practice location:
  • Phone: 215-273-3040
  • Fax:
Mailing address:
  • Phone: 973-670-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT034137
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: