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General NPI Number Information
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NPI Number | 1275067001
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Entity Type | Organization
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Legal Business Name | KENT INTEGRATIVE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 07/27/2017
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Provider Practice Location Address
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Address Line | 3616 ROYAL PALM ARCH
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-3608
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Country | US
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Telephone | 804-922-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 ROYAL PALM ARCH
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-3608
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Country | US
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Telephone | 757-447-7278
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | SHIRLEY KENT
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Credential | DPT
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Telephone | 757-447-7278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 2305208118
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2305208118
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License Number State | VA
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