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General NPI Number Information
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NPI Number | 1396131256
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Entity Type | Individual
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Provider Name | KEITH SLENK PT, DPT, ATC
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Gender | Male
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 3491 LINCOLN RD
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City | HAMILTON
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State | MI
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Zip | 49419-9533
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Country | US
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Telephone | 269-751-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 3491 LINCOLN RD
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City | HAMILTON
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State | MI
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Zip | 49419-9533
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501017074
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License Number State | MI
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