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General NPI Number Information
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NPI Number | 1760671184
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Entity Type | Individual
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Provider Name | LOU ANN KERNODLE PT
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 726 STATE FARM RD
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City | BOONE
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State | NC
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Zip | 28607-4945
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Country | US
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Telephone | 828-264-0501
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Fax |
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Provider Business Mailing Address
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Address Line | 844 BLAIRMONT DR
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City | BOONE
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State | NC
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Zip | 28607-8716
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Country | US
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Telephone | 828-265-2319
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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 | 2210
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License Number State | NC
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