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General NPI Number Information
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NPI Number | 1114187879
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Entity Type | Individual
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Provider Name | KENDRA PALUMBO
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 18510 N PARKVIEW PL
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City | SURPRISE
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State | AZ
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Zip | 85374-4294
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Country | US
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Telephone | 623-546-8011
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2103
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City | NAPERVILLE
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State | IL
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Zip | 60567-2103
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Country | US
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Telephone | 630-428-5850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 6182A
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License Number State | AZ
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