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General NPI Number Information
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NPI Number | 1336100015
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Entity Type | Organization
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Legal Business Name | KINEMATIC CONCEPTS PHYSICAL THERAPY & SPORTS REHAB
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 12952 BANDERA RD SUITE 107
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City | HELOTES
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State | TX
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Zip | 78023-4689
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Country | US
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Telephone | 210-372-9600
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Fax | 210-372-9923
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Provider Business Mailing Address
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Address Line | 12952 BANDERA RD SUITE 107
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City | HELOTES
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State | TX
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Zip | 78023-4689
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Country | US
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Telephone | 210-695-2682
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Fax | 210-598-0432
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Authorized Official
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Title or Position | CEO / CO-OWNER
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Name | CHAD A ELMS
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Credential | MPT, OCS, FAAOPMT
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Telephone | 210-372-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 647890000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 647890002
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License Number State | TX
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