Healthcare Provider Details

I. General information

NPI: 1245537398
Provider Name (Legal Business Name): KINEMATIC CONCEPTS PHYSICAL THERAPY & SPORTS REHAB, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 FREDERICKSBURG RD F-SVCE BLDG AT USAA
SAN ANTONIO TX
78288-0001
US

IV. Provider business mailing address

8627 CINNAMON CREEK DR SUITE 402
SAN ANTONIO TX
78240-1480
US

V. Phone/Fax

Practice location:
  • Phone: 210-696-8690
  • Fax: 210-694-0756
Mailing address:
  • Phone: 210-695-2682
  • Fax: 210-598-0432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. JOHN P MALFER
Title or Position: PRESIDENT/CO-OWNER
Credential: PT
Phone: 210-695-2682